Retinoschisis affects the retina, causing problems with the central or peripheral vision.
A person’s vision tends to worsen over time. In many cases, this is a natural result of aging, but it may sometimes be a sign of an underlying condition. Retinoschisis is present at birth in some people, but it can also develop with age.
In this article, we provide more information about retinoschisis, including the symptoms, causes, and treatment options.
Retinoschisis is a condition that occurs when the retina splits into two layers, affecting vision.
The retina is a layer of tissue at the back of the eye. It comprises cone and rod cells, which process light coming into the eye through the pupil. The retina sends visual signals to the brain through the optic nerve.
In people with retinoschisis, a layer of cells in the retina splits into two. This abnormality can affect vision in different ways, depending on where in the retina it occurs.
There are several types of retinoschisis, which can be hereditary or degenerative.
People who have the condition from birth likely have a type of hereditary retinoschisis, such as X-linked juvenile retinoschisis.
The condition can also develop over time with age, in which case it is degenerative retinoschisis.
Retinoschisis can affect a person’s ability to see. How the condition affects vision will depend on where in the retina it develops.
For example, the macula is an area of the retina that produces central vision. Retinoschisis can damage the macula, affecting central vision.
Retinoschisis in the macula affects an essential part of the vision, which allows someone to see shapes and colors straight ahead of them. Problems with central vision can make it difficult to perform daily activities, such as reading or driving.
Retinoschisis can also affect cells outside of the macula, leading to problems with peripheral vision. These issues make it difficult for a person to see things that lie outside the central gaze.
The cause of retinoschisis depends on its type.
Most cases of juvenile retinoschisis are the result of a mutation in the RS1 gene. This gene contains the information that the body needs to make retinoschisin. Studies suggest that this protein keeps the retina working properly.
When there is less retinoschisin due to this mutation, the retina can start to split. This split often occurs in the macular area, affecting central vision. The cause of juvenile retinoschisis in people without RS1 gene mutations is less clear.
Degenerative retinoschisis occurs as a result of aging. The cause is similarly unclear, but the condition is more common in older adults.
Most cases of retinoschisis do not affect central vision and may not require treatment. However, there are some things that a person can try:
Carbonic anhydrase inhibitors: In people with juvenile retinoschisis, carbonic anhydrase inhibitors may help with symptoms.
Vitamin A: While some people take vitamin A, there is a lack of evidence to show that it is effective in treating retinoschisis.
Surgery: In extreme cases, retinoschisis can lead to complete retinal detachment, which is where the retina pulls away from the back of the eye. It can lead to the complete loss of vision, and surgery may be necessary to move the retina back into place. If the detachment is the result of a small tear, a doctor may be able to repair it using laser treatment or cryotherapy.
The main risk factor for juvenile retinoschisis is genetics. People with a family history of retinoschisis are more likely to develop the condition.
For degenerative retinoschisis, the main risk factor is age. People over the age of 50 years are more likely to develop retinoschisis.
The likelihood of developing retinoschisis may also be higher in people with an increased risk of other eye problems. For example, some risk factors for retinal detachment include:
- injuries to the eye
- eye surgery
- severe nearsightedness
- diabetes that affects blood vessels in the retina
It is normal for vision to worsen with age. Glasses or contact lenses can help correct most mild vision problems.
It may be worth visiting a doctor or eye specialist if the problem becomes severe and affects daily functioning. A doctor may perform some diagnostic tests, such as an electroretinogram, to check for damage in the retina. An electroretinogram measures electrical activity in the retina in response to light.
It is advisable to see a doctor immediately if:
- there is a sudden increase in small dots floating around
- increased flashes of light affect the vision
- a dark shadow appears over the visual field.
These are all signs of retinal detachment and require immediate medical attention.
Retinoschisis is a condition that occurs when a layer of the retina splits into two. It can cause problems with the central or peripheral vision.
In some cases, the condition is present at birth, and in others, it will develop over time.
Retinoschisis does not always require treatment. However, serious cases, including those in which retinal detachment has occurred, will require surgery.