![]() ![]() These data indicate that patients with lattice degeneration with or without round holes are not at significant risk of subsequent retinal detachment without a previous retinal detachment in either eye. Clinical retinal detachments developed in three of the 423 eyes.5 Two were due to round retinal holes in lattice lesions of patients in their mid-twenties and one was due to a symptomatic tractional tear. ![]() Six other eyes developed new subclinical retinal detachments during follow-up. Byer studied 423 eyes with lattice degeneration in 276 patients over a period averaging almost 11 years.5 Of these, 150 eyes (35%) had atrophic holes in the lattice, and 10 of these 150 had subretinal fluid extending more than one disc diameter from the break. Generally, however, atrophic round holes within lattice lesions and minimal subretinal fluid do not require treatment. Treatment should be considered if the detachments are documented to increase in size.4,5 Younger myopic patients who have lattice degeneration with round holes need regular follow-up visits, because they can develop small, localized retinal detachments, which occasionally slowly enlarge to become clinical retinal detachments. Lattice degeneration can cause RRD by two mechanisms, including either round holes without PVD or tractional tears associated with PVD. ![]() The early diagnosis of a retinal detachment is also important because the rate of successful reattachment is higher and the visual results are better if detachment spares the macula.1,2 Successful treatment allows patients to maintain their abilities to read, work, drive, care for themselves, and enjoy a better quality of life.3 Lattice Degeneration The treatment of breaks/lattices before a significant detachment has occurred usually prevents progression, is uncomplicated and results in excellent vision. Currently, more than 95% of RRDs can be successfully repaired, although more than one procedure may be required. Because spontaneous reattachment is exceedingly rare, nearly all patients with asymptomatic RRD will progressively lose vision unless the detachment is repaired. Precursors to retinal detachments are PVD, symptomatic retinal breaks, asymptomatic retinal breaks, lattice degeneration, and cystic and zonular traction retinal tufts. Natural history of precursors to rhegmatogenous retinal detachment Manage patients at high risk of developing retinal detachmentĮducate high-risk patients about symptoms of PVD, retinal breaks, and retinal detachments and about the need for periodic follow-up. GOALS of identifying the patients with risk of RD are:Įxamine patients with symptoms of acute PVD to detect and treat significant retinal breaks ![]()
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