Comments and Conclusion (cont’d)

  • In a long term study of 218 consecutive eyes with retinoschisis followed for an average of 9 years, no case of macular involvement occurred. Since treatment of asymptomatic SR is risky in and of itself, it was concluded that no meaningful justification for treatment of SR had been established, and SR in a posterior location should only be observed every 2 or 3 years, unless the patient notices symptoms of extension caused by an associated detachment.3,4
  • Combined retinoschisis-detachment (schisis-detachment) is a complication of retinoschisis in which a portion of the outer layer becomes elevated above the pigment epithelial layer and in which the subretinal fluid communicates with the retinoschisis cavity through a hole in the outer layer. This constitutes a true retinal detachment, usually confined to the area of retinoschisis, which is combined with and is the result of senile retinoschisis.3,8
  • Symptomatic, progressive, frank retinal detachment is a rare complication of SR and the only complication for which surgery is mandatory. This complication occurs in only 0.05% of cases, or affecting one in 2000 patients.4
  • Because the number of patients in which retinoschisis leads to retinal detachment is extremely low, and because posterior extension is very slow and probably rarely extends to the macula, treatment should be used only very infrequently.9