Biography
Biography: Ingrid Kreissig
Abstract
Purpose: Senile retinoschisis is often misdiagnosed as rhegmatogenous retinal detachment, if holes are present, - not being diagnosed as inner retinal layer-, this can result in unnecessary treatment. Five patients with senile retinoschisis and “holes†in retina are followed up to 18 years.
Materials: In five patients, diagnosis of retinoschisis was in dispute, because round holes and horseshoe tears were present. None of the patients had symptoms. Visual acuity was 20/20, they were followed from 22 months to 18 years. All were myopic (-2,75 to -12 dpt). In 2, the retinoschisis was extending beyond 2 dd of macula.
Results: The patients were not treated at initial visit, but symptoms of retinal detachment and how to test visual field were explained and to come, if changes occur. The holes were identified by laser-test as holes/horseshoe tears in inner retinal layer. During follow-up in 4 eyes, the borders remained unchanged and no pigment demarcation line developed, in 1 of them several breaks developed in inner layer which subsequently disintegrated. In 1 eye, an outer layer break developed, retinal detachment resulted, reattachment occurred after sponge under outer layer tear, retinoschisis was unchanged. After longterm follow-up visual acuity remained 20/20 in all patients.
Conclusion: Differentiation of senile retinoschisis from rhegmatogenous retinal detachment might be difficult. Characteristics can define presence of retinoschisis: Retinal semitransparency, shallowness of elevation, absence of gravity component, no symptoms, no subsequent pigment demarcation line. Inner layer holes are confirmed by laser-test. OCT often is not possible, because of anterior location.