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LEDIANA GODUNI, Edmund Tsui, Kenneth J Wald; Acute horseshoe retinal tears: patient characteristics and outcomes after laser treatment.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4253.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate characteristics and outcomes, specifically recurrence of retinal tears and progression to retinal detachment, of patients presenting with acute horseshoe tears.
We retrospectively reviewed the electronic health records of a consecutive series of patients presenting to a retinal consultant practice with acute symptoms of vitreous separation who were found to have a typical horseshoe type retinal tear(s) (HST), without retinal detachment. 103 patients (115 eyes) were included from 2014 and 2017. All patients were examined by a single retinologist with indirect ophthalmoscopy, scleral indentation and contact lens biomicroscopy. The tears were treated by the same provider with transpupillary laser photocoagulation with the standard technique. All included eye had at least a 3 month follow up time.
There were 42 females and 61 males. Average age was 60.4yrs (range 27-83yrs). All eyes had a documented posterior vitreous detachment (PVD) at the time of presentation; 21.7% had vitreous hemorrhage. 22.6% of eyes had lattice degeneration. Of the 115 eyes, 86.1% were phakic; 13.9% were pseudophakic. Mean follow up time was 16mos (range 3-40mos).13% of all eyes experienced a new tear(s) in that same eye, 2 eyes (<2%) had a third break; 1 eye had a fourth break (<1%). In eyes with lattice degeneration occurrence of new tears was 19.2%, in eyes without lattice it was 11.2% and in eyes with previous cataract surgery it was 25%. New tears occurred between 14 and 789 days (2.16 years); 73.3% occurred within 3mos of initial presentation.7.0% of all eyes, 6.7% of eyes without lattice, 7.7 % of eyes with lattice and 12.5% of eyes with previous cataract surgery progressed to RD in the same eye. RD’s occurred at an average of 0.87mos (range: <1-4mos) after initial treatment; 75% of RD's occurred within 1mo.Epiretinal membrane (ERM), was seen in 10.4% of eyes treated for acute tears at an average of 12.4mos (range: <1-38mos) after presentation. As of yet, none of these eyes have required treatment for ERM.
Acute retinal tears demand careful follow up since new retinal tears occurred in 13% of all eyes, 19% of eyes with lattice and 25% of pseudophakic eyes. 73.3% of new tears occurred within 3mos. The rate of progression to RD was 7.0%, most occurring within 1mo. Close follow up, especially in the first few months, is critical for detecting and treating new tears and complications.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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