PMC7312967_01
Preoperative images of a 61-year-old Japanese woman with macula-involving retinal schisis secondary to branch retinal vein occlusion (BRVO). (a) An ultrawidefield fundus photograph showing BRVO with white vessels at the inferior temporal retina. The visual acuity in the left eye was 20/50. The lines indicate the location of OCT scans presented in (c) and (d). (b) Fluorescein angiography showing retinal neovascularization in the area of BRVO. (c) A horizontal optical coherence tomography (OCT) image through the macula showing macular traction and extensive retinal schisis. (d) A vertical OCT image through the macula showing broad adhesion of the vitreous and retinal schisis.
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The fluorescein angiogram showed retinal neovascularization in the nonperfused retina (Figure 1).
Postoperative images at two months after phacovitrectomy and membrane peeling for retinal schisis. (a) A horizontal optical coherence tomography (OCT) image showing the decreased height of retinal schisis. The schisis cavity is still wide in the temporal retina. (b) A vertical OCT image showing decreased but persistent retinal schisis.
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After the surgery, the decrease in the schisis cavity was observed with stable visual acuity between 20/50 and 20/40 (Figure 2).
A preoperative image before the second vitrectomy. An ultrawidefield fundus photograph showing the retinal detachment involving the macula at two and a half years after the initial surgery. The visual acuity in the left eye was counting fingers.
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Two and a half years after the initial surgery, she presented with macula-involving bullous retinal detachment (Figure 3).
Postoperative images at one and a half years after the removal of silicone oil. (a) An ultrawidefield fundus photograph showing retinal reattachment with retinal scars after photocoagulation. An outer retinal break is observed (arrow). The pale area indicates the location of the inner retinectomy. The visual acuity in the left eye was 20/60. The lines indicate the location of OCT scans presented in (b) and (c). (b) A horizontal optical coherence tomography (OCT) image showing the attached macula and thinning of the temporal retina. (c) A vertical OCT image showing the attached macula and a scar formation at the inferior macula.
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The retinectomy encompassed the inferotemporal peripheral retina and extended posteriorly into the macula, almost to the fovea (Figure 4); note that the inferotemporal arcade was truncated by the retinectomy. Her visual acuity was 20/60, and intraocular pressure was 10 mmHg at one and a half years after the last surgery (Figure 4).
The visual field of the left eye before and after surgeries. (a) A preoperative Goldmann perimetry test before the initial surgery showing the defect of the superior nasal visual field corresponding to the area with branch retinal vein occlusion. (b) A postoperative Goldmann perimetry test at three months after the silicone removal showing narrowing of the nasal visual field slightly, but the majority of the visual field was retained.
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The defect in her visual field slightly enlarged after the inner retinectomy (Figure 5).