Schwartz-Matsuo syndrome in retinal detachment with tears of the nonpigmented epithelium of the ciliary body

Purpose: To elucidate clinical features of Schwartz-Matsuo syndrome (photoreceptor outer segment glaucoma) occurring in retinal detachment with tears of the nonpigmented epithelium of the pars plana or plicata of the ciliary body. Methods: We reviewed retrospectively medical records of 17 consecutive patients (18 eyes) with retinal detachment caused by tears of the nonpigmented epithelium of pars plana (10 eyes) and pars plicata (8 eyes) of the ciliary body. Results: Aqueous cells, ranging from 1+ to 3+, were found in 15 eyes, in contrast with no cells in the other 3 eyes. Eleven of the 15 eyes with aqueous cells showed circadian fluctuation of the intraocular pressure with a range, 4 mmHg or wider compared with the range in the fellow eye, but only 4 of these 11 eyes had a maximum pressure of 21 mmHg or higher. Photoreceptor outer segments were detected in the aqueous humor of 8 eyes out of 14 eyes with aqueous cells in which aqueous tap was done. The remaining 6 eyes had too small a number of aqueous cells for electron microscopy. Conclusion: Marked fluctuation of the intraocular pressure compared with the fellow eye, which was not necessarily associated with its rise, was found in retinal detachment with tears of the nonpigmented epithelium of the ciliary body, and should be included as one of key features for diagnosis of Schwartz-Matsuo syndrome.