The natural history of senile retinoschisis.

The natural history of senile retionoschisis was studied by observing a series of 193 eyes of 108 nonreferred patients who had no history of significant ocular disease, while refraining from the use of any form of prophylactic intervention, for follow-up periods ranging from 2 to 11 years. One patient at the outset of the study had double layer holes, which had already led to a localized subclinical retinal detachment that had been left untreated, and did not progress during observation for more than two years. One patient developed a small asymptomatic nonprogressive retinal detachment from an outer layer hole. Four eyes showed posterior extension, but in only one was this serious. Nine eyes developed new retinal breaks, one in both layers, but none progressed in extent of retinoschisis or to retinal detachment. Of particular interest were seven eyes which showed unmistakable regression, the retinoschisis disappearing completely in six eyes. Based on reported cases, an estimated computation is made which places the probable risk of frank, progressive, symptomatic retinal detachment resulting from retinoschisis at about 0.07%. Four indications for treatment are given which are considered justified at the present state of our knowledge.