Retinal cleavage is a condition that causes the layers of the retina – the light-sensitive tissue at the back of the eye to split. The retina communicates with the brain about what the eye sees.

Having a retinal bification can affect a person’s vision; however, some people with this condition do not notice any changes in their vision. Retinal cleavage usually affects both eyes, but can also occur in each eye to different degrees.

Types of retinal cleavage

There are two types of retinal cleavage – one in which a person is born and the other that develops as they get older.

Retinitis X-related events

This type of retinal cleavage is a genetic disease that occurs most often in young people. In general, it infects one in 5000,25000 people to one in <>,<> people.

Retinal cleavage X-related events occur when an abnormal gene is carried on the X chromosome. Biological males have only one X chromosome. If the abnormal gene associated with retinal cleavage is present on that chromosome, a person can develop the condition and associated vision problems.

Biological females can also suffer from X-linked retinal cleavage caused by an abnormal gene on the X chromosome. However, because they have a second unaffected X chromosome, they usually have normal vision.

Degenerative retinal cleavage

Also known as acquired retinal cleavage or dementia, it is more common than the genetic form. It occurs equally between males and females.2 Overall, it affects about 4% of people aged 40 years and older

Retinal cleavage with cysts
In some cases of retinal schism, small cysts grow on the retina and may damage the nerves, leading to changes in vision. While it is not common to go blind due to retinal cleavage, the inherited form can cause poor vision.

How genetic disorders are inherited
Symptoms of retinal schism

Symptoms of retinal obstruction do not always appear, especially with the degenerative form. Often, the condition is monitored during an eye examination. In children, vision changes may not be detected until their vision is checked.

If a person has symptoms of retinal schism, they can include:

• Blurry vision
• Changes in vision that get worse over time
  Darker and darker vision
• Trouble seeing objects from the side (peripheral vision)
  People with the genetic form of the condition often experience abnormal eye movement and opacity (cataracts). They may also have other signs and symptoms, such as farsightedness and glaucoma

When to see a doctor

• Vision changes and blurry vision can have many causes and are not always caused by retinal cleavage. If you experience changes in your vision, an eye exam can help determine the cause.
• If sudden and new changes occur in your vision or you start to see flashes or small objects floating in your vision, make an appointment with your ophthalmologist immediately, as these can be signs of a more serious eye condition.

Causes

It is not clear why some people develop retinal schism and others do not.2 However, it is known that the genetic form is caused by an abnormal gene (mutation) and that the degenerative form is associated with aging.

Common causes of vision loss

Diagnosis

• Before diagnosing retinal bificment, ophthalmologists need to rule out similar conditions, such as retinal detachment or central serous choroidopathy.
• The diagnosis and treatment of retinal obstruction is usually handled by a type of ophthalmologist called a retina specialist.
• There are two main tests that ophthalmologists use to diagnose retinal schism: electroretinography and optical coherence tomography.

Electroretinography

• The electroretinal electrogram test measures the electrical sensitivity of retinal cells.5 During the test, an electrical sensor is placed on the eye to measure the electrical activity of the retina in response to light. The results are displayed on a screen for the ophthalmologist to review.
• An electroretinography can be difficult for children between the ages of 2 and 5. Children in this age group may need general anesthesia to take the test. Some ophthalmologists only perform the test on children under the age of two years or older than 5.1
• Effects of measuring the visual response of the eye to light
• Ultrasound or ultrasound
• Genetic testing
• To diagnose the genetic form of the retina

Computed tomography of optical coherence

• Ophthalmologists use optical tomography to detect many conditions and diseases. The test uses light to make a high-resolution hologram of the eye, especially the back.
• The test is similar to ultrasound, but instead of measuring sound, it measures light. The images are incredibly detailed and allow ophthalmologists to see things they wouldn’t be able to see using other imaging scans such as MRI.
• Computed tomography of optical coherence: what to expect
  other tests

There are also some other ways ophthalmologists can look for retinal cleavage, including:

• Effects of measuring the visual response of the eye to light
• Ultrasound or ultrasound
• Genetic testing
• To diagnose the genetic form of retinal bification, ophthalmologists may use genetic testing. While females can carry retinal bifida, they usually don’t have condition-related results on tests.
• Family tree analysis can help ophthalmologists explain how the condition is transmitted to patients – for example, X-linked retinal cleavage affects male family members on a regular basis.
• Genetic counseling can be helpful for people with genes associated with retinal cleavage.

Complications

Immediate diagnosis and treatment of retinal bification is necessary to prevent complications related to the condition, which can threaten a person’s vision.

Retinal detachment

Having a retinal fissure increases a person’s risk of developing a potentially vision-threatening condition called retinal detachment — when the retina detaches from the back of the eye. Retinal detachment occurs in 5% to 22% of people with the inherited form of retinosis

If retinal detachment is detected early, ophthalmologists can treat it with surgery to help prevent permanent vision loss.

What is retinal detachment?

Bleeding

• Another complication that can occur with retinal cleavage is gel bleeding that fills the back of the eye. The gel is called vitreous. When bleeding, it is called vitreous bleeding.
• If someone has vitreous bleeding, the ophthalmologist will use laser or cryotherapy to close the damaged area of the retina that is causing the bleeding.
• People with retinal fissure are sometimes advised not to participate in high-contact sports or activities that increase the risk of retinal detachment or vitreous bleeding.

Cysts

Sometimes, a type of eye medication called carbon anhydrase inhibitors can help treat cyst voids that occur during X-linked retinal cleavage.

Treatment

• People with X-related retinal diseases need regular eye exams — every six months to a year — to monitor the progression of the condition.
• People with the degenerative form of the condition often don’t need specific treatment. However, if they have certain symptoms or risk factors for complications, they have options for managing the condition.
• Conditions for eye
  examinations can be detected vision aids
• When a retinal obstruction obstructs a person’s vision, visual impairment aids can help them see better during their daily activities. Glasses can also help improve vision, but they won’t repair nerve damage in the retina caused by retinal cleavage.

Surgery

People with degenerative retinectoma usually don’t need treatment. However, if they develop complications such as retinal detachment, a type of surgery called vitrectomy may be recommended.

Retinal detachment surgery

References

The outlook of a person with retinal fissure depends on whether they have the genetic form of the disease or the type that develops with age.

The inherited form of retinal bifida is a lifelong disease that requires regular eye exams and careful monitoring. The degenerative form that can occur with age does not usually develop

Coping
If you or a loved one has been diagnosed with a retinal bific, keeping up with your eye doctor’s appointments will be important for your eye health.

If you have the genetic makeup, you’ll likely need to work closely with your eye doctor to monitor the progress of the condition and protect your vision.

If you have the form that develops as you get older, you may not need to take any specific steps unless you start having trouble with your vision or complications.

Helping your loved one overcome vision loss

A word from Ibsar Specialized Center

• Retinal cleavage is an eye condition that causes the layers of light-sensitive tissue at the back of the eye (retina) to split. It can affect one or both eyes and can be inherited or acquired.
• The genetic form of the condition usually occurs in young males and requires lifelong monitoring to prevent complications. The other, more common, form develops as people get older. It usually does not progress or requires specific treatment; however, people with vision problems related to this condition may benefit from using visual impairment aids to help them with their daily life activities.
• Having a retinal fissure can increase a person’s risk of vision-threatening complications, such as retinal detachment. Regular eye exams can detect these problems early and help ophthalmologists treat them early enough to protect a person’s vision.