About 25% of the general population have retinoschisis. Thetendency increases with age.
Idiopathic retinal splitting occurs, usually in the outer plex-iform layer.
. The patient will usuallynoticeareductionofvisualacuityandseeshadowsonlywhentheretinalsplitis severe and extends to the posterior pole.
Ophthalmoscopic examination will reveal bullousseparation of the split inner layer of the retina. The inner surface has theappearance of hammered metal. Rarely breaks will occur in the inner andouter retinal layers.
Rhegmatogenous retinal detachment
should beexcluded. Ophthalmoscopy will reveal a continuous break in the retina in aretinal detachment, and the retina will not appear as transparent as in reti-noschisis.However,retinalbreakscanalsooccurinretinoschisis.Intheinnerlayer of the retina, these breaks will be very small and hardly discernible. Inthe outer layer, they will be very large. Complete rhegmatogenous retinaldetachmentcanoccurinretinoschisisonlywherethereisabreakinbothlay-ers.
Usually no treatment is required. The rare cases in which retinaldetachment occurs are treated surgically using the standard procedures forretinal detachment.
Degenerative retinoschisis differs from retinal detachment in that it usuallyrequires no treatment.
Clinical course and prognosis.
The prognosis for degenerative retinoschisis isvery good. Progressive retinal splitting or retinal detachment with a sub-sequent reduction in visual acuity is rare.
Peripheral Retinal Degenerations
Peripheralretinaldegenerationsrefertodegenerativechangesthatlie parallel to the ora serrata in the peripheral portions of the retina. Theseinclude two basic types:
Harmless retinal changes
such as pars plana cysts of the posterior ciliarybody or peripheral chorioretinal atrophy (cobblestone degeneration).
Precursors of retinal detachment
such as local thinning of the retinareferred to as snail track or lattice degeneration.
The prevalence of the lesions is 6–10%.
Lang, Ophthalmology, 2nd. Ed. © 2006All rights reserved. Usage subject to terms and conditions of license.