title: Foveomacular schisis in juvenile X-linked retinoschisis: an optical coherence tomography study.
abstract: OBJECTIVE
  To explore the structural features of juvenile X-linked retinoschisis using spectral-domain optical coherence tomography (OCT).
  
  
  METHODS
  Retrospective, observational cross-sectional study.
  
  
  METHODS
  Eighteen male patients (34 eyes) who were diagnosed with juvenile X-linked retinoschisis at the Eye & ENT Hospital of Fudan University over an 18-month period were included. Their OCT images, which were obtained using spectral-domain OCT (Cirrus HD-OCT; Carl Zeiss Meditec), were analyzed. The anatomic location of the schisis cavity in juvenile X-linked retinoschisis was characterized by direct inspection of OCT images.
  
  
  RESULTS
  On OCT, the schisis cavity was visible at the fovea in all 34 eyes, and it was associated with increased retinal thickness. Schisis was present at the retinal nerve fiber layer in 4 eyes, at the inner nuclear layer in 29 eyes, and at the outer nuclear layer/outer plexiform layer in 22 eyes. In most cases, widespread foveomacular schisis was detected using OCT; however, in 9 eyes (6 patients), the schisis was confined to the fovea. Schisis of the inner nuclear layer and outer nuclear layer/outer plexiform layer almost always involved the foveal center, but retinal nerve fiber layer schisis was seen only in the parafoveal area.
  
  
  CONCLUSIONS
  Despite conventional wisdom, in patients with X-linked retinoschisis, the schisis cavity can occur in a number of different layers of the neurosensory retina (retinal nerve fiber layer, inner nuclear layer, and outer nuclear layer/outer plexiform layer). In addition, different forms of schisis may affect different locations in the macula (foveal vs parafoveal), and, in most eyes, the schisis involves the entire foveomacular region.
authors.affiliation: Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, People's Republic of China.
authors.forename: Jia
authors.initials: J
authors.lastname: Yu
authors.forename: Yingqin
authors.initials: Y
authors.lastname: Ni
authors.forename: Pearse A
authors.initials: PA
authors.lastname: Keane
authors.forename: Chunhui
authors.initials: C
authors.lastname: Jiang
authors.forename: Wenji
authors.initials: W
authors.lastname: Wang
authors.forename: Gezhi
authors.initials: G
authors.lastname: Xu
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004596:Electroretinography; D005451:Fluorescein Angiography; D005584:Fovea Centralis / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology; D012165:Retinal Ganglion Cells / Q000473:pathology; D041441:Retinoschisis / Q000175:diagnosis*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence