Acquired retinoschisis with giant outer layer break and retinal detachment

To evaluate the natural history of a case of retinoschisis with giant outer layer break and retinal detachment.

A 42-year-old patient with a sudden paracentral scotoma in the visual field of the right eye underwent the following examinations: best-corrected visual acuity, slit-lamp biomicroscopy, optical coherence tomography, ocular echography, and fundus photography.

The eye examination revealed inferotemporal retinoschisis-detachment with a giant outer retinal layer break and absence of foveal involvement. No breaks in the internal retinal layer were noted. No treatment was advised in the right eye. During the 3-year follow-up, a progressive reabsorption of subretinal fluid was detected and visual acuity remained unchanged.

Deliberate nontreatment of a case of nonprogressive retinoschisis-detachment carries less risk of serious complications or loss of vision than does either surgical or prophylactic treatment.