Work

From Observation to Surgery: A Review of Literature and an Updated Algorithm for Acquired Retinoschisis and Schisis-Detachment

Year: 2026

Type: article

Abstract: This review critically synthesizes current evidence regarding the natural history, advanced diagnostic imaging, and therapeutic interventions for acquired retinoschisis and retinoschisis-associated retinal detachment. A systematic search of PubMed and Embase databases was conducted for literature published up to 2026, focusing on comparative outcomes of scleral buckling versus pars plana vitrectomy and novel imaging modalities. The advent of ultra-widefield optical coherence tomography has shifted the diagnostic paradigm, enabling the precise identification of outer layer breaks as the primary biomarkers for progression. While observation is mandated for asymptomatic, non-progressive cases, the choice between buckling and vitrectomy for active detachments is often driven by surgeon preference rather than anatomical necessity. We propose an updated decision-making algorithm that integrates lens status, break localization, and vitreous findings to guide the surgical approach. Moving beyond a "one-size-fits-all" strategy, this review advocates for a personalized management plan that balances anatomical success with long-term quality of life.

Source: Medical Sciences

DOI: 10.3390/medsci14010159

Authors: Alessandra Scampoli, Tomaso Caporossi

Institutions: Agostino Gemelli University Polyclinic, Università Cattolica del Sacro Cuore

Language: English

Topic: Retinal and Macular Surgery

Subfield: Radiology, Nuclear Medicine and Imaging

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,689