[Treatment guidelines in various stages of senile retinoschisis]

Concerning the indications, progression in course and the possible complications, the different methods of treatment in cases of retinoschisis in its different expressions were examined. A staging of senile retinoschisis is presented.

Patients' natural course, prophylactic treatment against expansion and treatment of retinal detachment were examined.

The lateral and central barrier of laser or cryo around the schisis is contradictory since a progression in direction to the macula is the result. Three of such cases could be found. In 6 of 52 cases with prophylactic treatment of an outer layer defect 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 favourable outcome.

The only indication for treatment of a schisis at present is the symptomatic or progressive schisis detachment with threatening of the macula. Lateral or central barring of a schisis or treatment of the borders of an outer layer retinal break should be avoided. The rate of reattachment and the functional results are better than in the group of rhegmatogenous retinal detachments including the 50.5% schisis retinal detachments without symptoms.