Multimodal imaging findings of the fellow eye in Stellate Nonhereditary Idiopathic Foveomacular Retinoschisis (SNIFR).

Purpose: This study examines the multimodal imaging (MMI) findings in two cases of unilateral Stellate Nonhereditary Idiopathic Foveomacular Retinoschisis (SNIFR), including detailed findings from the unaffected fellow eye.

Methods: Macular spectral domain optical coherence tomography (OCT) and 3x3 mm optical coherence tomography angiography (OCTA), microperimetry, full-field electroretinography (ff-ERG) for both the affected and the fellow eye were reviewed.

Results: The MMI findings were consistent across the two cases (71-year-old female and 60-year-old female). OCT imaging of the affected eyes revealed cystoid spaces between the outer nuclear layer (ONL) and the outer plexiform layer (OPL), with the vascular network remaining intact, indicating no alterations in vessel flow. Microperimetry showed slightly lower pointwise sensitivity in both eyes compared to a normative database.

Conclusion: Although SNIFR typically presents as a unilateral condition, our findings suggest that patients may have an inherent structural predisposition to macular schisis, resulting in subtle functional impairments. We hypothesize that the structural damage may involve the macular Müller cells. These observations highlight the importance of further studies to understand SNIFR's pathophysiology and inform therapeutic approaches.