To review eyes with peripapillary and macular retinoschisis without a visible optic pit or advanced glaucomatous optic atrophy, or NOPIR (No Optic Pit Retinoschisis) DESIGN: Retrospective multi-center case series SUBJECTS: The study included 11 eyes of eleven patients.
Retrospective study of eyes with macular retinoschisis without a visible optic pit, advanced optic nerve head cupping, or macular leakage on fluorescein angiography.
Visual acuity (VA), retinoschisis resolution, months to resolution, recurrence of retinoschisis RESULTS: Mean age was 68.1 ± 17.6 years, mean intraocular pressure was 17.4 ± 3.8 mmHg, and mean spherical equivalent refractive error was -3.1 ± 2.9 diopters. No subject had pathological myopia. Seven subjects were treated for glaucoma, and nine subjects had nerve fiber layer defects on optical coherence tomography (OCT). All eyes had retinoschisis in the outer nuclear layer in the nasal macula and extending to the edge of the optic disc, and eight subjects had fovea-involving retinoschisis. Three non-foveal and 4 fovea-involved eyes were observed, and 4 fovea-involved eyes with vision loss had surgery. Surgery involved preoperative juxtapapillary laser followed by vitrectomy, membrane and internal limiting membrane peeling with intraocular gas and face down position. The mean baseline VA was significantly worse in the surgery group than that of the observation group (P=0.020). Retinoschisis resolved and vision improved in all surgical cases. The mean resolution time for the surgery group was 2.75 ± 0.96 months, which was shorter than the observation group (28.0 ± 21.2 months) (P=0.014). No eye developed recurrence of the retinoschisis after surgery.
Peripapillary and macular retinoschisis can develop in eyes without a visible optic pit or advanced glaucomatous cupping. Eyes without foveal involvement and those with foveal involvement but only mild decrease in vision can be observed for spontaneous resolution. If there is persistent foveal involvement with vision loss, surgery can improve vision by resolving the macular retinoschisis. Surgery for fovea-involved macular retinoschisis without a visible optic pit resulted in faster anatomic resolution and better vision recovery.

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