This is splitting of the sensory retina. The most common type is senile retinoschisis which occurs in about 3% of the population, increasing in frequency from the second decade onward. It begins as a cystic degeneration in the extreme periphery, most often at the ora serrata, and infrequently, may extend to involve the entire retinal periphery. Ophthalmoscopically, it appears as a transparent elevation of the retina. The inner wall is thin, intact and immobile, whilst the wall facing the pigment epithelium, is thick, has a honeycombed appearance and has large breaks. Frequently, both eyes are affected. The patient often complains of photopsia and floaters.
A harmless self limiting retinal detachment may follow leakage of the cavity through a hole in the outer wall. No treatment is indicated. Rarely, a hole occurs in both walls and initiates a serious rhegmatogenous detachment which must be treated.
An hereditary, X chromosome - linked retinoschisis may occur in children. This affects both the central and the peripheral retina. Vision is often normal in early childhood but deteriorates at puberty. Strabismus and nystagmus may occur.
Rarely, a peripheral retinoschisis occurs in retrolental fibroplasia or diabetic retinopathy.
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