![]() There is no clear consensus for management of atrophic retinal holes therefore, many practitioners elect to monitor. ![]() Careful examination and scleral depression is needed to distinguish between full-thickness and partial-thickness retinal holes, as their management can vary. As these can be considered “partial-thickness holes,” there is no threat for chronic flux of fluid to the subretinal space. The small crevices (blue arrow) noted within patches of lattice usually represent a partial excavation of the neurosensory retina. OCT shows a full-thickness break (blue arrow) and surrounding sub-and intraretinal fluid (red arrow) in the so called “cuff of fluid.” The progression of this fluid can lead to a chronically progressive rhegmatogenous retinal detachment. Lattice degeneration with multiple retinal holes. 1,2 Often, these holes are contained within, or are adjacent to, lattice degeneration and may be partial or full thickness ( Figures 3 and 4). While atrophic holes occur secondary to focal degeneration of the neurosensory retina and are not resultant from vitreous traction, they can exhibit surrounding areas of abnormal vitreoretinal adhesion ( Figure 2). Most patients exhibiting these have no associated symptoms. These are most often found during routine exam of the peripheral retina ( Figure 1). The above images display atrophic retinal holes (blue arrows) with surrounding regions of vitreoretinal adhesion (red arrows) visible in the images above and below. (C) A large atrophic hole noted in routine examination and subsequently treated with laser. The ring of pigmentation (blue arrows) is a reactive repair due to separation of neurosensory retina and the retinal pigment epithelium. Atrophic retinal hole (red arrows) noted both on (A) fundus photograph and (B) OCT. What follows is a pictorial, instructive guide depicting and describing various types of retinal holes and tears, their possible etiologies and management strategies.įig. Retinal defects come in different shapes and sizes and may be either partial or full thickness. Current research is also showing that ocular melanoma is very different from normal skin melanoma.Retinal holes and tears are commonly encountered during dilated fundus examination of both symptomatic and asymptomatic patients. Other sites include ciliary body, iris, and conjunctiva. Choroidal melanomas are the most common site comprising 85% of cases. There are other types of eye cancers, but melanoma is the most common. Ocular melanoma is often lethal, but thankfully, a very rare disease. Increased pressure can result in changes to blood vessels in the eye, increasing the risk of cardiovascular disease (stroke or heart disease). Glaucoma causes damage to the optic nerve and almost always develops without symptoms. The results in alterations to our fine central vision making daily activities difficult. The center of the retina (the macula) can become diseased when we get older. Retinopathy occurs when diabetes damages the tiny blood vessels inside the retina. Early detection is essential so treatments can be administered.ĭiabetes affects the eyes and the kidneys and is a leading cause of blindness. ![]() This means, in addition to eye conditions, signs of other diseases (such as stroke, heart disease, hypertension and diabetes) can also be seen in the retina. Your retina is the only place in the body where blood vessels can be seen directly. In this type, fluid leaks into the area underneath the retina (subretina).Įarly detection of all of these diseases and conditions mean successful treatments can be administered which reduces the risk to your sight and health. This type of detachment is less common.Įxudative – Frequently caused by retinal diseases, including inflammatory disorders and injury/trauma to the eye. Tractional – In this type of detachment, scar tissue on the retina’s surface contracts and causes it to separate from the RPE. These types of retinal detachments are the most common. Rhegmatogenous – A tear or break in the retina causes it to separate from the retinal pigment epithelium (RPE), the pigmented cell layer that nourishes the retina, and fill with fluid. What are the different types of retinal detachments? Anyone can get a retinal detachment however, they are far more common in nearsighted people, those over 50, those who have had significant eye injuries, and those with a family history of retinal detachments. If not promptly treated, a retinal detachment can cause permanent vision loss. When the retina detaches, it is lifted or pulled from its normal position.
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