An association between stellate nonhereditary idiopathic foveomacular retinoschisis, peripheral retinoschisis and posterior hyaloid attachment

Purpose Stellate nonhereditary idiopathic foveomacular retinoschisis (SNIFR) is a disorder characterized by splitting of the retina at the macula, without a known underlying mechanical or inherited cause. This study investigates demographic, anatomical and functional characteristics of subjects with SNIFR, to explore potential underlying mechanisms. Methods In this single-site, retrospective and cross-sectional, observational study, data were collected from 28 eyes from 24 subjects with SNIFR. Descriptive statistics were reported, based on the observed anatomico-functional features. Results Visual acuity remained stable (median 20/20) in all subjects over a median follow-up of 17 months. All cases demonstrated foveomacular retinoschisis within Henle's fiber layer, at the junction of the outer plexiform and outer nuclear layers. This schisis cavity extended beyond the limits of the macular OCT temporally in all eyes. In the majority of affected eyes, there were documented features of peripheral retinoschisis and broad attachment of the posterior hyaloid at the macula. Functional testing in a cross-sectional subset demonstrated normal retinal sensitivity centrally but an absolute scotoma peripherally. Conclusions Stellate nonhereditary idiopathic foveomacular retinoschisis appears to be associated with peripheral retinoschisis and anomalous or incomplete posterior hyaloid detachment. Despite chronic manifestation, this does not significantly affect central visual function, but can manifest with profound loss of peripheral visual function.