What Is Senile Retinoschisis?
Senile retinoschisis may also be known as acquired or degenerative retinoschisis. It is a gradual degenerative disease of the retina. The retina may gradually split into two or more layers in this condition. As the name suggests, this is not a senile condition but is found to occur in the third decade of life (20 to 30 years). This is mainly cystoid degeneration of the retina. Microcysts may be formed in the retina. Due to various changes, these cysts can join each other, separating the retina's layers.
How Common Is Senile Retinoschisis?
Senile retinoschisis occurs in almost four percent of the population. It is more common in individuals above 40 years of age. It may occur equally in males and females. It has no racial predilection. It is more common in individuals above 30 years. However, it has been reported in individuals less than 30 years of age.
What Are the Symptoms of Senile Retinoschisis?
Patients who are affected by this condition may remain asymptomatic for a very long period of time. The symptoms may vary from visual disturbances to loss of vision. The various symptoms this condition can present include:
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Reduction in Visual Acuity: A reduction in visual acuity means that a person finds it difficult to see letters, objects, or colors far away. This reduction of visual acuity can be due to the cysts that occur in the retina. This could be present in both eyes.
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Loss of Peripheral Vision: There could be a loss of peripheral vision. It could be present in both eyes or just one eye.
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Loss of Vision: Senile retinoschisis may be associated with a loss of vision that could be gradual. This is mainly due to retinal detachment that happens because of retinal dissociation.
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Floaters: The patient may complain of floaters in the vision. This can be due to the separation of the retina due to the cysts.
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Flickering: The patient may also complain of flickering in the eyes. This flickering is mainly due to the degenerative cysts that are formed between the retina.
What Are the Causes of Senile Retinoschisis?
The exact cause of the occurrence of senile retinoschisis is not known. This splitting of the retina occurs due to the merging of cysts that are formed within the retina. However, the exact cause of the formation of these cysts is unknown. It may be caused due to a degenerative process that takes place in the retina.
What Are the Complications of Senile Retinoschisis?
Senile retinoschisis may give rise to retinal detachment. The various complications that can occur with senile retinoschisis include:
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Schisis Cavity: In most cases where the retinal split occurs, the split extends posteriorly to the original location. This gives rise to cavity-like structures.
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Schisis Detachment: This is a condition where the schisis cavity totally detaches from the supporting structures. This may be similar to retinal detachment. This may even lead to loss of vision.
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Progressive Rhegmatogenous Retinal Detachment: Moderate rhegmatogenous retinal detachment results from breaks in both internal and external layers of the retina, permitting the vitreous medium to enter the retinal space. These inward wall breaks might happen from intense PVD (peripheral vascular diseases) and glassy footing. Nonetheless, they might be unconstrained and are often little and not handily envisioned.
How Can Senile Retinoschisis Be Diagnosed?
Most cases of senile retinoschisis are asymptomatic, and the diagnosis can be made through routine examination. The diagnosis of senile retinoschisis can be made by combining various diagnostic methods such as patient physical examination, laboratory diagnosis, and other diagnostic procedures. A good diagnosis can only be made with the combination of all of the above. The various diagnostic methods for senile retinoschisis include:
1. Physical Examination: Physical examination can be done using ophthalmoscopy with scleral depression. The various findings that could be elucidated in the physical examination are:
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The retina splits into multiple layers.
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The retina may be detached from the underlying layers.
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There could be a cavity formed in the retina.
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There could be cystic degeneration within the retina.
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The surface of the retina could appear elevated.
2. Other Examinations: Few other examinations can also be done to diagnose senile retinoschisis. These include:
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Imaging the Fundus - The imaging of the fundus can help assess the severity of the condition.
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Visual Field Plotting - (sharp outright scotoma in feeble retinoschisis; slanted comparative with outright in retinal separation). The plotting of the visual field aids in assessing the loss of the visual field. This tells about the progression of the condition.
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Low-Power Retinal Laser Test Spot - This test helps preclude subretinal liquid and retinal separation (in undeniably challenging cases). This test aids in checking for retinal detachment or separation. Due to the splitting into the layers of the retina, there could be a detachment of the retina. This could lead to the intermingling of various layers of the eye.
How to Treat Senile Retinoschisis?
Senile retinoschisis is not one of those conditions that resolve spontaneously. Once the layers are split, it can seldom get back to the normal configuration. The neuronal integration, once lost, is totally lost. So, if any vision loss occurs, it cannot be reversed. Surgery is the most common choice of treatment. Surgery may be undertaken to prevent the further splitting of the layers of the retina. It may be used to keep the internal and external layers of the retina intact. In the case of retinal detachment that is caused due to senile retinoschisis, surgery may be performed to fix the detachment. Since retinal detachment is very serious in nature and may even cause permanent blindness, immediate surgery may be performed.
Conclusion
Patients with senile retinoschisis may remain asymptomatic for a relatively long period of time. This is because the degeneration in the layers of the retina takes a while before displaying clinical symptoms. Once the degeneration sets in, it may display various symptoms, such as a decrease in peripheral vision and visual acuity. If a retinal detachment accompanies it, it could even lead to loss of vision. This condition also does not resolve independently and may require surgery to prevent further degradation. Hence, it is always better to undergo periodic eye check-ups to have healthy vision. Periodic check-ups can also catch such conditions at the starting itself, making treatment easier.
