X linked Retinoschisis Fundus presentation

X linked retinoschisis is a rare disorder of the retina seen in young individuals

1. FUNDUS PRESENTATION Dr. Ayushi Singh First Year Postgraduate Ophthalmology

2. A 15 year old male came with complaint of gradual decrease in vision in both eyes since 6 years His best corrected vision in RE is CF 1 metre and LE is CF close to face. His a nterior segment findings in BE are normal

3. family history patients father is a k/c/o juvenile retinoschisis since the age of 8 years and a k/c/o hypertension. Past history- patient presented at 9 yrs of age with decreased visual acuity of RE 6/18 and LE 6/24 and was prescribed glasses and dorsolamide eye drops patient went for visual acuity reassessment at 14 yrs of age with findings of RE 6/36 and LE 6/60 for far vision; and RE N8 and LE N12 for near vision. Upon fundus examination the findings are as such:

4. RIGHT EYE FUNDUS

5. RIGHT EYE: MEDIA: Clear OPTIC DISC: Shape , size and color are normal Margins well defined Mild Peripapillary atrophy temporally white flecks at posterior pole area

6. VESSELS: vessels are branching dichotomously into superior and inferior arcades. Arteries: veins – 1:3 Arteriolar attenuation present MACULA spoke wheel appearance branching out from the foveal area Foveal reflex absent Background retina- peripheral inferotemporal retinoschisis from 5 o clock to 10 o clock positions.

7. LEFT EYE FUNDUS

8. LEFT EYE: MEDIA: Clear OPTIC DISC: Shape , size and color are normal Margins well defined Mild Peripapillary atrophy present temporally - white flecks at post pole area

9. VESSELS: vessels are branching dichotomously into superior and inferior arcades. Arteries: veins – 1:3 Arteriolar attenuation present MACULA spoke wheel appearance branching out from the foveal area Foveal reflex absent Background retina- peripheral inferotemporal retinoschisis from 3 o clock to 7 o clock.

10. PROVISIONAL DIAGNOSIS The presence of spoke wheel pattern of foveal schisis associated with arterial attenuation and inferotemporal retinoschisis in a 14 yr old male with a positive family history is suggestive of X linked juvenile retinoschisis.

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