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Graefe's Archive for Clinical and Experimental Ophthalmology
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology 3/2020

01-03-2020 | Diabetic Retinopathy | Retinal Disorders

Effect of light and diurnal variation on macular thickness in X-linked retinoschisis: a case series

Authors: Yair Rubinstein, Chen Weiner, Noa Chetrit, Hadas Newman, Idan Hecht, Nadav Shoshany, Eran Pras

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 3/2020

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Abstract

Background

Diurnal variations in foveal thickness have been reported in several ocular pathologies including X-linked retinoschisis (XLRS), but its underlying mechanism is poorly understood. Rods are active under scotopic conditions with high metabolic demand, and its decrease may have positive effect on metabolic activity and macular thickness. The purpose of this study is to evaluate whether exposure to light and diurnal variation influence macular thickness in XLRS patients.

Methods

Five patients with clinical suspicion of XLRS underwent RS1 gene sequencing and optical coherence tomography measurements at three consecutive times: morning following sleep in a dark room, morning following sleep in an illuminated room, and late afternoon following sleep in an illuminated room. Central macular thickness (CMT) was compared between measurements, and molecular analysis was performed.

Results

Five RS1 mutations were identified: p.Gly140Arg, p.Arg141Cys, p.Gly109Glu, p.Pro193Leu, and p.Arg200His in patients 1–5, respectively. Two patients (4–5) had atrophied macula and were excluded from macular thickness variation analysis. A significant decrease in CMT between morning and afternoon measurements was observed in all patients (1–3: mean: 455.0 ± 32 μm to 342.17 ± 39 μm, 25%). Morning measurements following sleep in an illuminated room show a CMT reduction in all eyes of all patients with a mean reduction of 113 μm (mean: 547.17 ± 105 μm to 455.0 ± 32 μm, 17%).

Conclusions

Among XLRS patients, CMT decreased at the afternoon compared to the morning of the same day and may be reduced following sleep in an illuminated room. These results help shed light on the pathophysiologic process underlying intraretinal fluid accumulation involved with the disease.
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Metadata
Title
Effect of light and diurnal variation on macular thickness in X-linked retinoschisis: a case series
Authors
Yair Rubinstein
Chen Weiner
Noa Chetrit
Hadas Newman
Idan Hecht
Nadav Shoshany
Eran Pras
Publication date
01-03-2020
Publisher
Springer Berlin Heidelberg
Published in
Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 3/2020
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-019-04578-7

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