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A.C. Westfall, A. Maa, W. Mieler, E. Holz; Incidence of Retinal Tears and Late–onset Retinal Breaks in Eyes with a Symptomatic Posterior Vitreous Detachment . Invest. Ophthalmol. Vis. Sci. 2004;45(13):2066.
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Purpose:To report the incidence of retinal tears in eyes with a symptomatic posterior vitreous detachment (PVD) and the incidence of late–onset retinal breaks on follow–up examination. Methods:In a retrospective, consecutive, non–comparative case series, 223 eyes of 219 patients diagnosed with an acute symptomatic posterior vitreous detachment were reviewed. Exclusion criteria included a symptomatic PVD for longer than 30 days, previous retinal detachment due to other ocular pathology or previous ocular surgery (laser, cryo or vitrectomy). Data collected included age, sex, history of trauma, lens status, refractive error, presence of tear, anterior vitreous cells, retinal hemorrhage, vitreous hemorrhage, and the presence of lattice degeneration. Results:The incidence of retinal tears in eyes with an acute symptomatic PVD was 8.0% (18 out of 223). The average length of time from onset of symptoms to examination was 11 days with a range of 1 to 30 days. Of the remaining 205 eyes without a retinal tear, 138 follow–up examinations were performed. At the follow–up examination, only 2 out of 138 patients (1.4%) were found to have late–onset retinal breaks. One of the cases had a history of minor trauma (hit by a basketball in the head prior to developing symptoms), vitreous hemorrhage, lattice and moderate myopia. The second patient did not have a retinal break at the one month follow–up examination, but 3 months later developed a retinal tear. The second patient did not have any risk factors for a retinal tear other than the prior PVD. Conclusion:Symptomatic posterior vitreous detachments are associated with retinal tears. Our experience of a 8.0% retinal tear rate in patients with an acute symptomatic PVD is within the range reported in the literature. In addition, we found that the rate of late–onset retinal breaks is low.
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