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March 1973

Retinal Detachment

Author Affiliations

Los Angeles

Arch Ophthalmol. 1973;89(3):259. doi:10.1001/archopht.1973.01000040261019

To the Editor.  —Some aspects of the otherwise excellent report titled Giant tear dialysis in the outer layer of retinoschisis, by Drs. Wilson and Dodson (Arch Ophthalmol) 88:336, 1972), require comment. In our studies of the polymorphous degenerations of the peripheral retina, we have found it useful to categorize lesions according to their manifest or implied cause as "trophic" or "tractional." If the authors use the term "tear" as it has been defined in our laboratory (meaning a tractional lesion of the retina derived from the pulling by vitreous or zonule), then the interpretation of the lesion in this case is not consonant with my pathologic studies.1,2 Breaks in the outer wall of senile retinoschisis are trophic (ie, related to local nutritional factors; most likely ischemia of subjacent choroid). In a previous report,1 I illustrated a lesion with an extremely large outer-wall hole1(Fig 7) and a

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