What Is a Scleral Buckle?

Retinoschisis refers to the division of the retinal neuroepithelial layer into the inner and outer layers. Generally includes congenital hereditary retinoschisis and acquired retinoschisis. Congenital hereditary retinal schizophrenia is more common in male children and rare in females. Acquired retinal schizophrenia occurs frequently in the elderly. More than 80% of the cases are binocular, and both eyes are symmetrical, and there is no difference in gender. Often see a doctor for symptoms such as a flash or mosquitoes.

Basic Information

Visiting department

Ophthalmology

Common causes

Congenital factors, emmetropic or hyperopia can cause.

Common symptoms

Vision impairment or vision loss

Contagious

no

Causes of Retinoschisis

1. The basis of acquired retinal schizophrenia is peripheral microcystic degeneration.
2. Congenital retinal schizophrenia is a recessive hereditary disease of the X chromosome, but there are also reports of autosomal recessive inheritance and autosomal dominant inheritance. The mother is the carrier, and the cleft is symmetrical.

Retinoschisis clinical manifestations

1. Congenital hereditary retinal schizophrenia is often found in the school age or preschool vision defects. When amblyopia on one side of the affected eye often has disused exotropia, low vision in both eyes is prone to nystagmus, and spontaneous vitreous hemorrhage occurs occasionally. The cleaved inner layer bulges into the vitreous body with a gauze film shape, with various sizes and shapes. Holes of various sizes and shapes can appear on the gauze film. Mottled clefted outer walls can be observed through the holes. Retinal detachment can occur when the split inner and outer layers are ruptured.
2. The early lesions of acquired retinal schizophrenia are located in the peripheral part of the temporal side of the fundus, and there are no symptoms before the progression. In the future, mosquito vision, flashing light, and vision loss may appear. At the junction of the split edge and the healthy retina, there is occasionally a so-called dividing line with pigment. The disease occurs in the emmetropic or hyperopic eyes and is rarely accompanied by myopia. 80% of the eyes are involved and bilaterally symmetrical. Occurred at most in the peripheral temporal retina below the temporal. Nasal people are very rare.

Retinoschisis examination

1. Fundus examination of congenital hereditary retinoschisis shows the following manifestations.
(1) The vitreous body is atypical of fine fiber agglomeration, cavitation formation, and later detachment and concentration. Schizophrenia is usually spherical.
(2) White sheaths are often seen in the blood vessels above the split inner layer. Multiple round and oval holes may appear in this layer.
The split outer layer may also have small cracks.
(3) Field of vision. Congenital retinal schizophrenia often has a relative central dark spot.
(4) Vitreous hemorrhage is common in young patients.
2. Acquired retinal schizophrenia (1) Fundus findings: There is a narrow cystic zone at the anterior edge of the retinal cleft to separate the cleavage area from the zigzag margin; The split inner layer, on which retinal blood vessels are visible, are often accompanied by white sheaths, which can rupture and bleed when stretched. Holes of different sizes and shapes are visible.
(2) Visual field examination: Absolute visual field defect occurs when the macula is involved.

Retinoschisis diagnosis

1. Congenital hereditary retinal schizophrenia can be diagnosed based on poor vision in the eyes of a child from an early age and what he sees in the fundus. If there is a visual field defect that is consistent with fundus changes, such as congenital retinal schizophrenia, there is often a relative central dark spot to confirm the diagnosis.
2. Acquired retinal schizophrenia (1) This disease is more common in older people with emmetropic or hyperopic eyes. Macular involvement may cause absolute visual field defects.
(2) Fundus examination showed that there was a narrow cystic area at the leading edge of the retinal cleft to separate the cleft area from the serrated margin.
It can be diagnosed based on typical manifestations and fundus examination.

Retinoschisis treatment

1. Congenital Retinoschisis The preventive treatment of congenital Retinoschisis is still controversial. When the splitting may endanger the macula, a laser can be used as a preventive dam-type photocoagulation around the retina that is not raised at the trailing edge of the splitting, in order to limit the splitting to the posterior pole. If retinal neovascularization occurs, photocoagulation is recommended for the occluded area, but neovascularization can sometimes degenerate on its own.
2. Acquired retinal schizophrenia (1) Those whose cleavage range has expanded backwards or beyond the equator. Photocoagulation or condensation of the entire diseased area can also be performed on healthy retinas adjacent to the rear edge of the diseased area.
(2) When there are cracks on the inner and outer walls, the cracks are closed by photocoagulation or condensation at the edges of the cracks. It is also possible to close only the outer wall cracks, leaving the inner wall cracks untreated.
(3) Those with retinal detachment are an important indication for surgery. Scleral buckling was performed and the outer hiatus was closed.