TREATMENT GUIDELINES IN DIFFERENT STAGES OF SENILE RETINOSCHISIS

Background Concerning the indications, progression in course and the p ossible complications, the different methods of treatment in cases of retinoschisis in its different expressions were examined. A staging of senile retinoschisis is presented. Patients Patients' natural course, prophylactic treatment against expansion and treatment of retinal det achment were examined. Results The lateral and central barrier of lase r or cryo around the schisis is contradictory since a progression in d irection to the macula is the result. Three of such cases could be fou nd. In 6 of 52 cases with prophylactic treatment of an outer layer def ect with cryo the result was a schisis detachment. In all these cases a retinal reattachment was performed with the Custodis procedure. The final anatomic result of 95 treated schisis retinal detachments was a 98% success. The symptomatic or progressive cases had a little less fa vourable outcome. Conclusions The only indication for treatment of a s chisis at present is the symptomatic or progressive schisis detachment with threatening of the macula. Lateral or central barring of a schis is or treatment of the borders of an outer layer retinal break should be avoided. The rate of reattachment and the functional results are be tter than in the group of rhegmatogenous retinal detachments including the 50,5% schisis retinal detachments without symptoms.