Degenerative Retinoschisis with Giant Outer Layer Breaks and Retinal Detachment

Foveal Involvement by Acquired Retinoschisis

“…Another patient (Patient 7) had progression but not into the foveola, There are other reports of vision loss by such a mechanism. [2][3][4][5] How can central vision and fixation remain intact if retinoschisis extends into the fovea? A hypothesis is suggested by the orientation of the inner fibers of the foveal cones, that is, by Henle fiber layer.…”

“…1 Three reports have described the development of outer layer holes (OLHs) and then outer layer detachment and progression and preventive surgical techniques. 2,3,4 Methods We surveyed 7 patients who first presented with retinoschisis in one eye with a posterior edge within 10°of the temporal fovea. Two of these patients had peripheral scleral buckling surgery soon after presentation; the surgery was ineffective and did not affect the retinoschisis.…”

Perspectives on the management of the complications of senile retinoschisis

“…Even this change does not of itself merit urgent treatment. I was able to find only eight documented cases contained in two reports in the American literature 14,20 of eyes with definite extension of 'schisisdetachment' posteriorly, beyond the border of the retinoschisis. However in two of these the extension did not reach the macula.…”

“…Several reports of large outer layer breaks involving up to 135 arcuate degrees suggest that such eyes may be more susceptible to secondary progressive retinal detachment. [14][15][16] However in 1995, in attempting to diminish this danger, Clemens et al 17 reported that in retinoschisis with outer layer breaks larger than one hour in size, treatment with cryotherapy actually caused progression to a schisis-detachment in 11% of 52 eyes.…”

“…They include vitrectomy, external drainage of the schisis cavity, inner layer retinotomy and internal drainage of schisis fluid and subretinal fluid, endolaser, gas-fluid exchange with long-acting gases with postoperative positioning of the patient, and use of heavy perfluorocarbon liquids to tamponade the schisis and detachment during surgery. 14,15,20,[24][25][26] None of these reports record more than a very few cases.…”