Retinoschisis

Dr Ben Wild

Overview

Our vision comes from light waves stimulating retinal photoreceptors and these photoreceptors transferring their signals through the several different cells along the various layers of the retina and onwards to the brain.

A frontal view of a healthy retina.

Retinoschisis is a condition where the layers of the retina start to separate from each other. It starts as tiny microcysts (pockets of fluid within the retina) that merge to create large areas of separation. Retinoschisis is seen in 5% of people, most of which are farsighted. There are 3 main types; degenerative, where the photoreceptor layer has separated, typical, where the outer plexiform layer (the layer next to the photoreceptors) has separated, and reticular, where the nerve fiber layer has separated.

A frontal view of a retina with retinoschisis.

Signs and Symptoms

Signs

Smooth convex immobile dome of retina seen in both eyes 80% of the time, if there is a pigment line at the edge, there is likely also a retina detachment, white sclerosed blood vessels overtop, snowflake debris, microaneurysms, inner and/or outer retinal breaks.

Symptoms

Usually asymptomatic (no symptoms), very rare noticeable blind spot, rare vitreous hemorrhage/retinal detachment symptoms.

Causes and Risk Factors

Causes

There are no known causes.

Risk Factors

Genetics, farsightedness.

Prevention and Treatment

Prevention

There are no known preventative measures.

Treatments

· Close monitoring every 1-2 years for size progression.

· Laser retinopexy surgery with progression.

· Vitrectomy surgery with vitreous hemorrhage (bleeding in the vitreous cavity).

Prognosis

Retinoschisis is not usually a condition that affects vision or lead to any visual issues or even require surgery or treatment. It usually progresses slowly with very rare bleeding into the vitreous humor gel. In 1% of patients, a retinal detachment is possible and therefore careful monitoring is required.