title: Incidence, mechanism and outcomes of schisis retinal detachments revealed through a prospective population-based study.
abstract: To determine the incidence, presentation and outcomes of progressive sight-threatening retinal detachment (RD) complicating degenerative retinoschisis.
  
  
  
  We conducted the first prospective population-based epidemiological study of progressive schisis detachment over a 1-year period (2014-2015) in the UK. Case ascertainment was via monthly British Ophthalmological Surveillance Unit reporting cards sent to all ophthalmologists in the UK. For each reported case, data were collected using incident and 6 months follow-up questionnaires gathering information including demographic, presenting symptoms, retinal findings, primary management, primary outcome, secondary management and secondary outcome.
  
  
  
  Fifty-five cases of progressive schisis RD were identified with similar age distribution to conventional rhegmatogenous RD (mean age 64.0 years, range 20-88), and male-to-female ratio of 2.3:1. The locations of schisis detachments were predominantly supratemporal (46.7%) and infratemporal (35.6%). At least 70% of schisis RD were associated with posterior vitreous detachment (PVD) at presentation and 21% with grade B-C proliferative vitreoretinopathy. Primary management consisted of pars plana vitrectomy (82%), scleral buckle (9%), observation (4%), laser (2%) and combined vitrectomy-buckle (2%). Primary reattachment rate was 70%. Final reattachment rate was 87% with mean best-corrected visual acuity of 0.49 Decimal (SD 0.34) for fovea-on and 0.42 Decimal (SD 0.29) for fovea-off schisis detachments at mean follow-up of 8.7 months (SE 1.0).
  
  
  
  The estimated annual incidence of progressive schisis RD was 0.85 per million population (95% CI 0.64 to 1.11), equivalent to around 0.66% of all rhegmatogenous RD. PVD may play a key pathogenic role in the development of progressive schisis detachments. Surgical outcomes are inferior to those of conventional rhegmatogenous RD.
authors.affiliation: Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.|Nuffield Laboratory of Ophthalmology, University of Oxford, Oxford, UK.
authors.forename: Kanmin
authors.initials: K
authors.lastname: Xue
authors.affiliation: Moorfields Eye Hospital, London, UK.
authors.forename: Mahiul M K
authors.initials: MMK
authors.lastname: Muqit
authors.affiliation: Moorfields Eye Hospital, London, UK.
authors.forename: Eric
authors.initials: E
authors.lastname: Ezra
authors.affiliation: Department of Ophthalmology, Manchester Royal Eye Hospital, Manchester, UK.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Charles
authors.affiliation: Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, UK.
authors.forename: David
authors.initials: D
authors.lastname: Yorston
authors.affiliation: Birmingham Midland Eye Centre, City Hospital NHS Trust, Birmingham, UK.
authors.forename: Arijit
authors.initials: A
authors.lastname: Mitra
authors.affiliation: Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
authors.forename: Chetan K
authors.initials: CK
authors.lastname: Patel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D053685:Laser Therapy / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012163:Retinal Detachment / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D041441:Retinoschisis / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D012591:Scleral Buckling / Q000379:methods; D006113:United Kingdom / Q000453:epidemiology; D014821:Vitrectomy / Q000379:methods; D055815:Young Adult
keywords: Epidemiology; Retina; Vitreous