This 59YO female was initially seen with asymptomatic retinoschisis in her left eye. When examined six months later, the schisis appeared stable.
16 months later, the schisis cavity was slightly enlarged in all dimensions with the formation of an early outer layer hole. Most recently, the outer layer hole enlarged, and the schisis spontaneously mostly collapsed, essentially resolving itself. Continued observation was recommended.
Learning Points:
Degenerative schisis cavities can enlarge, and in these cases, prophylactic treatment including thermal laser does not prevent further spread and is therefore not recommended (Ness et al, Surv Ophthalmology 2022;67;892-907).
Schisis very rarely progresses into the fovea (Byer Ophthalmology 1986;93:1127-1137) and even then is compatible with preserved central vision as long as the outer layer remains attached (Watzke et al 2013;33:606-612).
Our patient shows how the life cycle of a schisis cavity is often dynamic, including enlargement, development of inner or outer layer breaks, and resolution.
