Background
Senile retinoschisis (RS), also known as acquired or degenerative retinoschisis, is a primary, acquired, gradual splitting of the retina into at least 2 distinct layers. This condition is not senile or age related, as it has been reported in patients in the third decade of life (20-30 years).
Pathophysiology
Senile retinoschisis 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.
Epidemiology
Frequency
United States
The prevalence of senile retinoschisis is high in the normal population (4-22% of individuals older than 40 years).
Mortality/Morbidity
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%).
Sex
The occurrence of senile retinoschisis is approximately equal in males and females.
Age
Senile retinoschisis 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. [1]
Prognosis
In a large study conducted by Byer, no change in visual acuity occurred over 9 years (from extension of senile retinoschisis or retinal detachment). [2]
Generally, senile retinoschisis does not progress. About 3.2-13.5% of cases progress within 9-10 years of diagnosis.
Even with anatomic correction, the visual field deficits are permanent.
Patient Education
Patients with senile retinoschisis should be informed about symptoms of retinal detachment.
