N E Byer1. 1. Clinical Professor (Emeritus) of Ophthalmology University of California School of Medicine Los Angeles, CA 90505, USA. nebyer@earthlink.net
Abstract
PURPOSE: To evaluate various published views regarding the management of complications of senile retinoschisis. METHODS: To analyze and compare various reports of studies of natural history and prognosis, and comparative risks of non-intervention vs prophylactic surgery. RESULTS: Although a number of recent techniques for treatment or prevention of complications of senile retinoschisis have been reported with generally satisfactory results, the numbers of cases have been small and no consensus can be said to have been achieved as to superiority of method. When compared to the extremely low likelihood of the natural occurrence of complications such as posterior progression to involve the macula, or of the development of progressive clinical retinal detachment, as well as the occurrence of risks of treatment, it appears preferable to postpone treatment until these complications actually make their appearance. CONCLUSIONS: It is recommended that in cases of retinoschisis either without or with breaks, or retinoschisis with localized 'schisis-detachment', that prophylactic treatment be withheld except in a very few exceptional cases. In all cases of progressive, symptomatic rhegmatogenous retinal detachment however, prompt surgical treatment should be carried out.
PURPOSE: To evaluate various published views regarding the management of complications of senile retinoschisis. METHODS: To analyze and compare various reports of studies of natural history and prognosis, and comparative risks of non-intervention vs prophylactic surgery. RESULTS: Although a number of recent techniques for treatment or prevention of complications of senile retinoschisis have been reported with generally satisfactory results, the numbers of cases have been small and no consensus can be said to have been achieved as to superiority of method. When compared to the extremely low likelihood of the natural occurrence of complications such as posterior progression to involve the macula, or of the development of progressive clinical retinal detachment, as well as the occurrence of risks of treatment, it appears preferable to postpone treatment until these complications actually make their appearance. CONCLUSIONS: It is recommended that in cases of retinoschisis either without or with breaks, or retinoschisis with localized 'schisis-detachment', that prophylactic treatment be withheld except in a very few exceptional cases. In all cases of progressive, symptomatic rhegmatogenous retinal detachment however, prompt surgical treatment should be carried out.