This 71YO female was treated elsewhere with barrier laser around degenerative schisis in her right eye. Over the past 9 months, the inferotemporal schisis cavity has gradually enlarged. The yellow line indicates the original location of schisis. At the most recent visit on 10/6/21, the schisis cavity extended through the barrier laser.
Triton swept-source OCT scanning through this area confirmed pure schisis with no retinal detachment. She remains completely asymptomatic, and we continue to recommend observation.
Learning Points:
This patient is at virtually no risk of a combined schisis-rhegmatogenous detachment due to the absence of inner and outer layer breaks.
Schisis cavities can enlarge, and in these cases, prophylactic treatment, including thermal laser, does not prevent further spread.
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).
