Alessandro Feo, Andrea Govetto, Prithvi Ramtohul, Néda Abraham, Diogo Cabral, Peter Y Chang, Nauman Chaudhry, Fred K Chen, Dean Eliott, Livia Faes, Rachael C Heath Jeffery, Sarah Mrejen, Marko M Popovic, Marisa G Tieger, Luca Zatreanu, SriniVas R Sadda, K Bailey Freund, Mario R Romano, David Sarraf
{"title":"Stellate Nonhereditary Idiopathic Foveomacular Retinoschisis and Central Anomalous Retinoschisis with mid-PEripheral Traction (CARPET).","authors":"Alessandro Feo, Andrea Govetto, Prithvi Ramtohul, Néda Abraham, Diogo Cabral, Peter Y Chang, Nauman Chaudhry, Fred K Chen, Dean Eliott, Livia Faes, Rachael C Heath Jeffery, Sarah Mrejen, Marko M Popovic, Marisa G Tieger, Luca Zatreanu, SriniVas R Sadda, K Bailey Freund, Mario R Romano, David Sarraf","doi":"10.1016/j.oret.2025.01.019","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To report the clinical and multimodal imaging (MMI) findings and long-term follow-up of stellate nonhereditary idiopathic foveomacular retinoschisis (SNIFR) contiguous with midperipheral retinoschisis (MPRS) and to describe a severe SNIFR variant termed CARPET (Central Anomalous Retinoschisis with mid-PEripheral Traction).</p><p><strong>Design: </strong>Retrospective case series.</p><p><strong>Subjects: </strong>Eleven patients (15 eyes) with SNIFR contiguous with MPRS in at least 1 eye at baseline or final follow-up.</p><p><strong>Methods: </strong>Multimodal imaging features, including cross-sectional and en face macular and peripheral spectral-domain OCT and OCT angiography, were reviewed in all cases at baseline and at the final follow-up visit.</p><p><strong>Main outcome measures: </strong>Various courses (including progression, regression, or stability) of MPRS or SNIFR over time were evaluated.</p><p><strong>Results: </strong>Midperipheral retinoschisis exhibited centripetal progression to SNIFR in 5 eyes of 3 patients with follow-up of 67, 60, and 27 months, respectively, with maintenance of excellent visual acuity (range: 20/25-20/20) in 4 of these 5 eyes. In 2 eyes of 2 patients (including 1 eye with initial centripetal progression of MPRS to SNIFR), MPRS contiguous with SNIFR spontaneously resolved with long-term follow-up (77 and 25 months, respectively). Stellate nonhereditary idiopathic foveomacular retinoschisis contiguous with MPRS partially regressed after 48 months in 1 patient, and was stable after 54 months in another. A distinctive midperipheral microvasculopathy, associated with MPRS that was contiguous with SNIFR, was identified in 7 eyes of 4 patients. Finally, 3 eyes of 3 patients exhibited additional unique features, including central neurosensory detachment and outer lamellar macular hole, which were associated with significant midperipheral traction, representing a severe variant subtype of SNIFR that we refer to as CARPET. Two of these 3 eyes progressed with short-term follow-up of 6 and 2 months, respectively, whereas the schisis resolved and vision improved after pars plana vitrectomy in the third case.</p><p><strong>Conclusions: </strong>Midperipheral retinoschisis can progress to SNIFR over multiple years of follow-up. Stellate nonhereditary idiopathic foveomacular retinoschisis with MPRS can also spontaneously resolve or remain stable. Midperipheral retinoschisis can additionally be complicated by a midperipheral inner retinal microvasculopathy. Finally, CARPET may represent a unique and severe variant form of SNIFR driven by midperipheral vitreoretinal traction and associated with significant vision loss.</p><p><strong>Financial disclosure(s): </strong>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4000,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ophthalmology. Retina","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.oret.2025.01.019","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: To report the clinical and multimodal imaging (MMI) findings and long-term follow-up of stellate nonhereditary idiopathic foveomacular retinoschisis (SNIFR) contiguous with midperipheral retinoschisis (MPRS) and to describe a severe SNIFR variant termed CARPET (Central Anomalous Retinoschisis with mid-PEripheral Traction).
Design: Retrospective case series.
Subjects: Eleven patients (15 eyes) with SNIFR contiguous with MPRS in at least 1 eye at baseline or final follow-up.
Methods: Multimodal imaging features, including cross-sectional and en face macular and peripheral spectral-domain OCT and OCT angiography, were reviewed in all cases at baseline and at the final follow-up visit.
Main outcome measures: Various courses (including progression, regression, or stability) of MPRS or SNIFR over time were evaluated.
Results: Midperipheral retinoschisis exhibited centripetal progression to SNIFR in 5 eyes of 3 patients with follow-up of 67, 60, and 27 months, respectively, with maintenance of excellent visual acuity (range: 20/25-20/20) in 4 of these 5 eyes. In 2 eyes of 2 patients (including 1 eye with initial centripetal progression of MPRS to SNIFR), MPRS contiguous with SNIFR spontaneously resolved with long-term follow-up (77 and 25 months, respectively). Stellate nonhereditary idiopathic foveomacular retinoschisis contiguous with MPRS partially regressed after 48 months in 1 patient, and was stable after 54 months in another. A distinctive midperipheral microvasculopathy, associated with MPRS that was contiguous with SNIFR, was identified in 7 eyes of 4 patients. Finally, 3 eyes of 3 patients exhibited additional unique features, including central neurosensory detachment and outer lamellar macular hole, which were associated with significant midperipheral traction, representing a severe variant subtype of SNIFR that we refer to as CARPET. Two of these 3 eyes progressed with short-term follow-up of 6 and 2 months, respectively, whereas the schisis resolved and vision improved after pars plana vitrectomy in the third case.
Conclusions: Midperipheral retinoschisis can progress to SNIFR over multiple years of follow-up. Stellate nonhereditary idiopathic foveomacular retinoschisis with MPRS can also spontaneously resolve or remain stable. Midperipheral retinoschisis can additionally be complicated by a midperipheral inner retinal microvasculopathy. Finally, CARPET may represent a unique and severe variant form of SNIFR driven by midperipheral vitreoretinal traction and associated with significant vision loss.
Financial disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.