Senile retinoschisis (SR) is a primary, acquired, gradual splitting of the retina into 2 distinct layers. This condition is not senile or age related, as it has been reported in patients in the third decade (20-30 y).
SR develops from the coalescence of intraretinal microcysts located in an area of peripheral cystoid degeneration near the ora serrata and extends posteriorly and circumferentially. This process leads to the splitting of the retina at the outer plexiform layer or, less commonly, at the inner nuclear layer.
The prevalence of senile retinoschisis is high in the normal population (4-22% of individuals older than 40 y).
Often, no visual changes occur, but retinal detachment may occur in a small percentage of patients, leading to visual field defects and/or decreased visual acuity.
Visual field defects may manifest as the schisis cavity extends posteriorly.
The schisis cavity may remain stable or slowly progress over several years.
Retinal detachment may result after the development of retinal holes in both the inner layer and outer layer of the schisis cavity or in the outer layer alone (16%).
The occurrence of SR is approximately equal in males and females.
SR is more common in patients older than 30 years, but it has been reported in patients younger than 30 years.
In a long-term follow-up study (n=946), the age-standardized prevalence of retinoschisis was 3.9% (95% confidence interval, 2.6-5.2) in persons aged 60-80 years.