No Optic Pit Retinoschisis (NOPIR): A Risk Factor for Glaucoma

无视神经凹陷性视网膜劈裂症(NOPIR):青光眼的一个危险因素

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Abstract

Purpose: Peripapillary and macular retinoschisis can occur without visible optic pits or advanced glaucomatous optic atrophy, a condition referred to as no optic pit retinoschisis (NOPIR). This study sought to further define the clinical features of NOPIR in a single-center case series. Methods: A retrospective study of consecutive cases of NOPIR was performed at The University of Osaka Hospital in Japan. The clinical characteristics and treatment history of patients were reviewed. Results: In total, 13 eyes of 12 patients with NOPIR were included. At baseline, the mean (±SD) age was 65.8 ± 10.3 years, mean intraocular pressure was 14.9 ± 3.9 mm Hg, and mean refractive error was -2.12 ± 2.4 diopters. Two eyes had moderate glaucoma at baseline. Ten eyes (91%) did not have glaucoma at baseline; however, glaucoma developed later after the initial diagnosis. The mean time from baseline to glaucoma diagnosis was 31.6 ± 15.2 months. Of the 13 eyes, retinoschisis associated with NOPIR was treated with vitrectomy in 6 eyes and with observation in 7 eyes. The time to resolution of retinoschisis was shorter in the surgery group (mean ± SD 14.7 ± 7.6 months) than in the observation group (52.4 ± 21.4 months) (P = .005). The time to diagnosis of glaucoma was also shorter in the surgery group (9.5 ± 12.8 months) than in the observation group (35.6 ± 16.1 months) (P = .02). Conclusions: Eyes with NOPIR can have glaucoma present at the time of diagnosis, but it more commonly develops later thereafter. Screening for glaucoma and visual field testing should be considered in eyes with NOPIR.

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