X-linked retinoschisis.

This 14-year old teen complained of blurred vision both eyes for several years. He noted when looking at objects with his left eye he had to turn his head or look around the object to see it. His visual acuity was 20/40-2 in the right eye and 20/50-2 in the left eye. Intraocular pressures were normal bilaterally. The slit lamp exam was normal. The fundus exam showed a normal optic disc in both eyes and bilateral macular retinoschisis . There was no peripheral retinoschisis, but white without pressure was present bilaterally. The top and middle images show areas of spoke-like cystic foveal changes. (see teal arrows). The OCT images show macular retinoschisis cavities. Several maternal uncles have visual acuity problems. These findings and family history are consistent with X-linked retinoschisis. The patient was given education and asked to return to his ophthalmologist yearly. Although this patient had no peripheral retinoschisis, as many as 50% of patients also have this finding.