What is retinoschisis?

Retinoschisis is a common ophthalmologic disease. If it progresses, the retina undergoes degenerative-dystrophic changes, the retinal layers begin to divide and disintegrate into outer and inner ones. Retinoschisis is associated with impaired circulation in the retina. At first, the pathology proceeds secretly: the patient can not understand that he is sick.

Definition of disease

Retinoschisis is a disease characterized by retinal bundle.This pathology is caused by separation by the choroidal and vitreal layer, i.e. external and internal layers of the retina. This disease refers to the degenerative and leads to a series of visual abnormalities until complete blindness.

The disease occurs on the basis of degenerative changes in the structures of the retina or as a result heredity, in particular pathological changes in the vascular system, anomalies in the development of the ocular apple and other

. The incidence of the disease is from 4% to 12% without sex. Age restrictions - from 40 years and more, except for the congenital factor.

Because retinosis has no pronounced symptomatology at the initial stages of development, and is determined clinically already in neglected cases, this leads to low recovery rates after diagnosis and treatment.

Retinoschisis is a long-term, constantly progressive disease of a chronic nature with severe consequences.

Causes

Pathology occurs against the background of malformations of the visual organs.A common cause of retinosis is the dystrophic mechanisms that occur in the retina. There are many cases where retinosis is transmitted at the genetic level. If the child was diagnosed with a congenital form of the disease, the symptoms manifest up to 10 years.

It is important to diagnose it in a timely manner: thus avoiding complications. The difficulty in diagnosing is that most patients do not complain about vision impairment.

Disease, as a rule, is detected accidentally. The ophthalmologist sees narrowing of the fields of vision.

Classification

There are three types of retinoschisis:

1. Degenerative.Pathology is acquired, it is more often diagnosed in persons older than 40 years. The cause of degenerative retinoschisis - dystrophic changes in different parts of the retina (macular, peripheral). The disease is divided into 2 types: typical and reticular.
2. Hereditary.The disease occurs due to genetic disorders. A predisposing factor may be Wagner's disease.
3. Secondary.The disease develops in people who have suffered from vascular eye diseases: it can be a central vein vein thrombosis, diabetic retinopathy, chronic forms of uveitis, iridocyclitis. Secondary retinosis is also associated with inflammatory diseases of the eyes. This ailment can occur against the background of a trauma to the organ of vision. Possible predisposing factor - oncology of the choroid.

There are cases when secondary retinoschisis develops with improper intake of medications.

One of the main causes of the disease is the impaired blood flow in the macular area.With retinoschisis the dystrophic process develops on the periphery of the retina. Pathology is also accompanied by cystic degeneration. Formed cysts merge and form cavities within the retina. These cavities are exfoliated, retinal structures die. All these processes lead to detachment of the retina.

There are three stages of retinoschisis.

1. On the first, the retina is cleaved at a certain site. Around this site, intra-retinal fluid is formed.
2. In the second stage, the retinal membrane is split.In the layers of the retina, micro-cysts are formed.
3. In the third stage, the retina cavities are ruptured.

Symptoms

Retinoschisis does not make itself felt for a long time.When the pathology develops, the plexiform layer is affected. Degenerative-dystrophic reactions extend to the temporal periphery. In the future, extensive areas with small-cystic dystrophy are formed. With the spread of pathological processes on the macula occurs retinal detachment. Are narrowing the field of view. A person sees things vaguely, can complain about "flashing of flies".

Secondary retinoschisis in children often occurs against the background of eyeball pathologies. Symptoms depend on the manifestations of the underlying ailment. Usually they are the same as in adults.

Possible complications

If untimely to treat retinoschisis, there will be a vast retinal detachment.There is a hemorrhage under the retina and vitreous body. The quality of vision is significantly deteriorating.

Diagnostics

Diagnostic techniques:

1. Visometry;
2. Ophthalmoscopy;
3. Tonometry;
4. Ultrasound of the eyeball;
5. Perimetry;
6. Coherence tomography.

Vision, ophthalmoscopy, tonometry are used to determine visual acuity, primary eye examination and intraocular pressure.During the procedures, a slit lamp is used.

Tonometry of the eye

If suspicions of retinosis have been noticed, ultrasound of the eyeball is prescribed.Computer perimetry allows you to determine the defects of the field of view.Optical coherence tomography is performed to identify degenerative-dystrophic changes in the macular area.
During the examination, the doctor determines the cysts, reveals detachments on the retina. Differential diagnostics makes it possible to distinguish retinosis from vasculitis.

Treatment

Treatment of retinoschisis - exclusively complex therapy,since only medicamental, conservative or surgical will not give a positive result.

Medication

The goal of conservative therapy is to improve microcirculation, restore metabolic processes in the organ of vision.Treatment should ensure the prevention of retinosis. The doctor prescribes vitamins, antioxidant drugs. Nootropic therapy is performed. The duration of treatment is determined by the doctor.

Laser coagulation

Laser therapy is used to stop the progression of pathology. For this purpose, laser retina coagulation is used. This method allows to achieve tissue fusion between the retina and the choroid. It is used for choroidal and peripheral dystrophy.

The advantages of the procedure:

1. Bloodless method of intervention.
2. Prophylaxis of dystrophic changes in the retina and retinoschisis.
3. Virtually no complications.
4. During the procedure, the heart, vessels and internal organs undergo minimal stress.
5. Does not require a long recovery.

Laser coagulation is prescribed for various pathologies of the retina. These can be vascular diseases, tumors (in this case, the type of education is taken into account).

The procedure itself lasts 20 minutes, then the patient returns home. ATDuring the intervention, the doctor uses a lens, through which the image falls into the deep structures.The procedure is controlled through a microscope.

Laser coagulation results in diabetic changes in the retina, central vein thrombosis. Indication for the procedure is also angiomatosis. To perform this type of manipulation requires drip anesthesia.

Extrascoral filling

This method involves filling the sclera.The operation is prescribed with a pronounced retinal detachment. In the course of surgical intervention, the retina is squeezed through a special bundle. The surgeon fixes the seal on the sclera directly in the area of ​​the rupture.

Extrascleral filling can lead to complications, including macular fibrosis, retinal atrophy, rejection of a seal.

Manipulation has contraindications, including hemophthalmus and dystrophic changes of the vitreous.In the latter, the procedure may be performed depending on the individual case, but will be limited in functionality of the seal.

Extrascleral filling is performed using a fine-mesh silicone tool.First, the bulbar conjunctiva is cut. The retina is divided into quadrants. The conjunctiva is cut in the affected quadrant. Separate devices are used to fix the oculomotor muscles. Diathermocoagulation is then carried out. The seal is fixed on the sclera using seams. At the end of the process, an antibacterial medicine is administered.

Antibacterial therapy lasts 7 days.During this period, it is necessary to control the intraocular pressure. If it rises, the doctor prescribes hypotensive drops. If necessary, the patient is recommended non-steroidal anti-inflammatory drugs. In the recovery period, hormonal medications can be prescribed: everything depends on the success of the operation. Sutures are removed after 3 days.

Prevention

1. Regular visit to the ophthalmologist.
2. Exclusion of physical activity in myopia.
3. Avoidance of stress.
4. Competent and timely treatment of glaucoma.
5. Use of drugs to restore pressure (if necessary).
6. Protection of eyes from injury.
7. Observance of the recommendations of an ophthalmologist.

Video

conclusions

The prognosis of retinosis depends on the effectiveness of treatment, as well as on the type of pathology (secondary, hereditary). This disease affects the quality of vision. If it was transmitted hereditarily, the prognosis, as a rule, is not very good. The prognosis for the secondary form depends on the effectiveness of the treatment of the primary disease.