Patient Presentation: A 23-year-old obese female was diagnosed with idiopathic intracranial hypertension (IIH) and referred to neurosurgery for ventriculoperitoneal shunt. A baseline ocular examination was performed prior to the procedure.

On examination, vision was 20/200 in the right eye, and 20/40 in the left eye. There was a right relative afferent pupillary defect. Slit lamp examination was normal.

A dilated fundus examination was performed demonstrating the following:

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Retina

Case 6

Patient Presentation: A 6-year-old male was referred to retina clinic for decreased vision in both eyes. He has a family history of myopia. On examination, vision was 20/80 OD and 20/70 OS. Slit lamp and fundus examination appeared normal. An OCT macula was performed and demonstrated the following:

Retina Case 6-1

Retina 6-2

Describe the OCT

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Given the clinical scenario, what is the likely diagnosis?

A. Cystoid Macular Edema

B. X-Linked Juvenile Retinoschisis

C. Outer Retinal Tubulation

D. Retinal Telangiectasia Type 2

Question: What investigation is most useful to definitively diagnose the condition?

Retina Case 6-1

A. Fundus Autofluorescence

B. Fundus Photographs

C. Full-Field ERG

D. Genetic Testing

Learning Objectives:

1. Recognize the typical OCT appearance of macular retinoschisis.

2. Understand the differences in appearance of retinoschisis and macular edema on OCT.