Byer N E
Clinical Professor (Emeritus) of Ophthalmology University of California School of Medicine Los Angeles, CA 90505, USA.
Eye (Lond). 2002 Jul;16(4):359-64. doi: 10.1038/sj.eye.6700191.
To evaluate various published views regarding the management of complications of senile retinoschisis.
To analyze and compare various reports of studies of natural history and prognosis, and comparative risks of non-intervention vs prophylactic surgery.
Although a number of recent techniques for treatment or prevention of complications of senile retinoschisis have been reported with generally satisfactory results, the numbers of cases have been small and no consensus can be said to have been achieved as to superiority of method. When compared to the extremely low likelihood of the natural occurrence of complications such as posterior progression to involve the macula, or of the development of progressive clinical retinal detachment, as well as the occurrence of risks of treatment, it appears preferable to postpone treatment until these complications actually make their appearance.
It is recommended that in cases of retinoschisis either without or with breaks, or retinoschisis with localized 'schisis-detachment', that prophylactic treatment be withheld except in a very few exceptional cases. In all cases of progressive, symptomatic rhegmatogenous retinal detachment however, prompt surgical treatment should be carried out.
评估关于老年视网膜劈裂症并发症处理的各种已发表观点。
分析并比较关于自然病程和预后的各种研究报告,以及非干预与预防性手术的相对风险。
尽管近期已报道了一些治疗或预防老年视网膜劈裂症并发症的技术,总体结果令人满意,但病例数量较少,且对于哪种方法更具优势尚未达成共识。与诸如向后进展累及黄斑、发生进行性临床视网膜脱离等并发症自然发生的极低可能性以及治疗风险相比,似乎最好推迟治疗,直到这些并发症实际出现。
建议对于无裂孔或有裂孔的视网膜劈裂症病例,或伴有局限性“劈裂性脱离”的视网膜劈裂症病例,除非在极少数特殊情况下,应暂缓预防性治疗。然而,对于所有进行性、有症状的孔源性视网膜脱离病例,应立即进行手术治疗。