title: Stellate nonhereditary idiopathic foveomacular retinoschisis.
abstract: OBJECTIVE
  To describe a new classification of stellate nonhereditary idiopathic foveomacular retinoschisis (SNIFR).
  
  
  METHODS
  Retrospective case series and literature review.
  
  
  METHODS
  A total of 17 patients from 5 institutions.
  
  
  METHODS
  Detailed case history, multimodal imaging, and genetic testing were reviewed for patients with macular schisis without a known predisposing condition. Patients with a stellate appearance centered on the fovea with correlating confirmed expansion of the outer plexiform layer (OPL) by optical coherence tomography (OCT) were included. Exclusion criteria included a family history of macular retinoschisis, a known genetic abnormality associated with retinoschisis, myopic traction maculopathy, epiretinal membrane, vitreoretinal traction, optic or scleral pit, or advanced glaucomatous optic nerve changes.
  
  
  METHODS
  Clinical features, anatomic characteristics, and visual acuity.
  
  
  RESULTS
  A total of 22 eyes from 16 female patients and 1 male patient with foveomacular schisis were reviewed from 5 institutions. Initial visual acuity was ≥ 20/50 in all eyes (mean, 20/27), but visual acuity in a single eye decreased from 20/20 to 20/200 after the development of subfoveal fluid. The refractive status was myopic in 16 eyes, plano in 3 eyes, and hyperopic in 2 eyes. Three eyes had a preexisting vitreous separation, and 19 eyes had an attached posterior hyaloid. Follow-up ranged from 6 months to >5 years.
  
  
  CONCLUSIONS
  In this largest known series of patients with SNIFR, all patients demonstrated splitting of the OPL in the macula with relatively preserved visual acuity (≥ 20/40) except in a single patient in whom subretinal fluid developed under the fovea.
authors.affiliation: Retina Consultants of Michigan, Southfield, Michigan. Electronic address: obermike@gmail.com.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Ober
authors.affiliation: Vitreous-Retina-Macula Consultants of New York, New York.
authors.forename: K Bailey
authors.initials: KB
authors.lastname: Freund
authors.affiliation: Department of Ophthalmology, Henry Ford Health Systems, Detroit, Michigan.
authors.forename: Manthan
authors.initials: M
authors.lastname: Shah
authors.affiliation: Department of Ophthalmology, Henry Ford Health Systems, Detroit, Michigan.
authors.forename: Shareef
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina.
authors.forename: Tamer H
authors.initials: TH
authors.lastname: Mahmoud
authors.affiliation: Retinal Specialists of Michigan, Grand Rapids, Michigan.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Aaberg
authors.affiliation: Kellogg Eye Institute, University of Michigan, Ann Arbor, Michigan.
authors.forename: David N
authors.initials: DN
authors.lastname: Zacks
authors.affiliation: Department of Ophthalmology, Henry Ford Health Systems, Detroit, Michigan.
authors.forename: Hua
authors.initials: H
authors.lastname: Gao
authors.affiliation: Vitreous-Retina-Macula Consultants of New York, New York.
authors.forename: Krishna
authors.initials: K
authors.lastname: Mukkamala
authors.affiliation: Department of Ophthalmology, Henry Ford Health Systems, Detroit, Michigan.
authors.forename: Uday
authors.initials: U
authors.lastname: Desai
authors.affiliation: Rush University, Chicago, Illinois.
authors.forename: Kirk H
authors.initials: KH
authors.lastname: Packo
authors.affiliation: Vitreous-Retina-Macula Consultants of New York, New York.
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Yannuzzi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005136:Eye Proteins / Q000235:genetics; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D016133:Polymerase Chain Reaction; D012160:Retina / Q000473:pathology*; D041441:Retinoschisis / Q000145:classification* / Q000175:diagnosis* / Q000503:physiopathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology
chemical_list: D005136:Eye Proteins; C108726:RS1 protein, human