78 year old male with primary open angle glaucoma (POAG) with peripapillary retinoschisis.

<p>(1A) Optic nerve photograph shows glaucomatous optic neuropathy (1B) There is mild visual field damage with a mean deviation of -2.19 dB. (1C, 1D and 1E) Three horizontal OCT raster scans through three different sections of the optic nerve demonstrating peripapillary retinal splitting (retinoschisis) with adherent vitreous in the region of retinoschisis (yellow arrow), splitting in the nerve fiber layer (yellow star), and inner plexiform layer (white star) and outer plexiform layer with a likely outer nuclear layer component as well (white arrows). (1F) Circumpapillary retinal nerve fiber layer (RNFL) thickness map shows retinoschisis nasally within the RNFL segmentation (yellow star), causing a small area of artifactual thickening on the RNFL thickness profile.</p

Clinical characteristics of the eleven eyes of seven patients with peripapillary retinal splitting (schisis).

<p>Clinical characteristics of the eleven eyes of seven patients with peripapillary retinal splitting (schisis).</p

67 year old male with advanced POAG, with peripapillary retinochisis.

<p>(2A) Optic nerve photograph shows glaucomatous optic neuropathy. (2B) There is advanced visual field damage, with a mean deviation of -19.65 dB. (2C) OCT demonstrates peripapillary retinoschisis in the outer nuclear layer and outer plexiform layer (C; white arrows) on two horizontal raster scans through the optic nerve. (2D) Circumpapillary RNFL thickness map shows retinoschisis nasally.</p

Distribution of diagnosis in eyes with and without peripapillary retinal splitting (schisis).

<p>Distribution of diagnosis in eyes with and without peripapillary retinal splitting (schisis).</p

A Geometrical Approach to a New Unified Field Theory

To identify the risk factors for development of peripapillary retinal splitting (schisis) in patients with glaucoma or suspicion of glaucoma.Glaucoma Clinic, Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL.In this institutional cross-sectional study, 495 patients (990 eyes) who had undergone spectral-domain optical coherence tomography (OCT Spectralis HRA-OCT, Heidelberg Engineering) optic nerve head (ONH) imaging and did not have identifiable optic nerve pits, pseudopits or coloboma were included. OCT scans were reviewed by two observers.Presence of peripapillary retinal splitting identified on OCT raster scans.Eleven of 990 glaucoma and glaucoma suspect eyes (1.1%) of 7 patients (2 females, 5 males, mean age 64.5 ± 9.2 years) had peripapillary retinal splitting. Two of these 11 eyes had extension of the splitting into the macula but none to the fovea. Of these 11 patients, 2 (28.6%) were glaucoma suspects, 3 (42.9%) had primary open-angle glaucoma, 1 (14.3%) had chronic angle-closure glaucoma and 1 (14.3%) had pigmentary glaucoma. 7/11 (63.6%) eyes had vitreous traction to the disc visualized on OCT and 6/11 eyes (54.5%) had beta-zone peripapillary atrophy.We observed peripapillary retinal splitting in 1.1% of a series of 990 glaucoma and glaucoma-suspect eyes. Evidence of adherent vitreous with traction and peripapillary atrophy was found in a majority of the involved eyes. A comparison to an age and axial length matched cohort is required to determine if this is a condition that is associated with glaucoma