|Year : 1982 | Volume
| Issue : 6 | Page : 551-553
Clinical study on secondary degenerative retinoschisis in retinal detachment cases
4, Maharaja Nanda Kumar Road, Calcutta-700 029, India
D P Ganguli
4, Maharaja Nanda Kumar Road, Calcutta-700 029
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Ganguli D P. Clinical study on secondary degenerative retinoschisis in retinal detachment cases. Indian J Ophthalmol 1982;30:551-3
Retinoschisis or splitting of the neural layer of the retina was noted first in 19331sub and was termed Retinoschisis by Wilczek in 19352sub and usually may be classified as congenital, senils or secondary. Secondary degenerative retinoshisis may develop in large number of conditions, the most common of which are long standing retinal detachments, choroidal tumours and retinal vascular diseases. In retinal detachment cases their globular appearance with pinkish tint of various sizes with the retinal vessels stretched over them in the detached retina are very characteristic.
| Materials and methods|| |
9 cases of retinoschisis in retinal detachment cases were studied by the author at the Retina Research Centre, Medical College, Calcutta. They were examined in the conventional ways with direct, indirect ophthalmoscopes and Goldmann 3 mirror contact lens preoperatively and most of the cases post-operatively.
| Discussion|| |
Controversy exists regarding the origin of this type of retinoschisis. Some authors had defined them as true retinal cyst, but histopathological appearance of such cases studied by Keith, Zimmerman and Naumann suggestive of pseudocyst or the proper term retinochisis. Zimmerman and Naumann studied histopathologys with stains for acid mucopolysaccharide but they failed to detect mucoid material invariably present in microcystoid degeneration and senile retinoschisis. Their disappearance after retinal reattachment in most of the cases confirm the opinion of Schepens. Their association with small peripheral break and lattice degeneration in most of the cases were found significant. In 2 cases schisis contained blood (case 3 and 9) and follow up examination in case No. 9 showed a grey circular area at that particular site. According to Wolter, haemosiderin in the wall of the retinal cyst give a brown colour of the cyst and may also interfere with transillumination. Thus, retinal cyst may simulate melanoma of the choroid very closely and eyes have been unnecessarily removed because of such pigmented cysts'.
| Summary|| |
1. Retinoschisis following retinal detachment reattaches spontaneously after retinal reattachment and do not need any additional interference.
2. Spontaneous reattachment of the schisis suggestive of intraretinal reversible ischaemic degenerative process involved in the accumulation of fluid in the neural layers.
3. Their genesis are not always dependent on long standing retinal detachment.
4. Their predominance in younger age group are not very apparent as suggested by some authors 4.
5. Their recognition is important because they may be mistaken for retinal breaks to an inexperienced observer.
6. Collection of blood in the schisis cavity may simulate a flat type of malignant melanoma later on and proper charting of the retina is essential to avoid unnecessary removal of an eye.
| References|| |
Bartels, M, 1933, Klin. Mbl. Augenh. 91 : 437
Wilezek, M., 1935, Z. Augenh. 85: 108-116.
Schepens, GL., 1938, New and controversial aspect of retinal detachment. P. 438-439-Alice Mc Pherson, Hoeber Medical Div., Harper and Row, New York, Evanston, London.
Spencer, W.H., 1966, Retinal Diseases, Ed. by Samuel J, Kimura and Wayne M. Caygill. Lea and Febiger, Philadelphia.
Keithi 1966, Brit. J. Ophthalmol. 50 : 617.
Zimmermann, L.E. and Naumann, G., 1968, New and controversial aspect of retinal detachment, P. 408 (see No. 4 above).
Wolter, J.R., 1964, Surv. Ophthalmol. 9 : 135.
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