The Role of Photocoagulation in the Management of Retinoschisis

Senile retinoschisis versus retinal detachment, the additional value of peripheral retinal OCT scans (SL SCAN‐1, Topcon)

“…Laser photocoagulation as a diagnostic test is based on the retinal blanching effect of photocoagulation, present when the neurosensory retina is attached to the RPE. In senile retinoschisis, the outer layer is assumed to be attached and would therefore blanch easily in contrast with a detached retina (Okun & Cibis 1964). Landers and Robinson showed that this test does not always distinguish correctly (Landers & Robinson 1977).…”

Use of Spectral-Domain Optical Coherence Tomography to Differentiate Acquired Retinoschisis From Retinal Detachment in Difficult Cases

“…8,9 A spot of laser to the area of schisis will result in laser uptake, whereas there will be no visible laser uptake in the area of chronic RD. However, there have been reports of visible laser uptake by the retinal pigment epithelium in cases of chronic detachment, reducing the specificity of this as a diagnostic test.…”

“…7 Finally, laser uptake by the outer leaf in RS is another useful test that may help distinguish between these two different pathologies. 8,9 This is because the outer leaf in RS remains in apposition to the retinal pigment epithelium, and the heat energy generated from laser uptake by the retinal pigment epithelium produces a visible coagulative burn in the outer retinal layer of the schisis. Despite all this, it can still be difficult to unequivocally differentiate between an RS and an RD, particularly if the detachment is chronic or exudative in nature.…”

Perspectives on the management of the complications of senile retinoschisis

“…However the American ophthalmic literature includes no more than seven published cases of proven macular involvement. [4][5][6][7] The well known report by Okun and Cibis in 1964 4 of eight cases was later corrected to only three cases which were caused by senile retinoschisis. 8 Some think that treatment should be given to far posterior cases, but it is not possible to know which cases should be treated.…”