Original ArticlesEvidence-based analysis of prophylactic treatment of asymptomatic retinal breaks and lattice degeneration
Section snippets
Methods
With the dedicated assistance of the AAO PPP Retina Panel,3 the author conducted a MEDLINE literature search of articles published in English from 1966 to the present. Search words included retinal detachment, posterior vitreous detachment, lattice degeneration, retinal tear, retinal hole, retinal break, vitreoretinal degeneration, and prophylactic therapy. Additional pertinent articles from a variety of textbooks and older journals had previously been collected by the author.4 These
Results
All recommendations regarding therapy were considered to be level A, most important to the quality of the patients’ care. However, the strength of the evidence used to support the recommendations was surprisingly weak. No prospective randomized clinical trials regarding the prevention of retinal detachment have been published. Of the 25 recommendations regarding treatment that were published in the new PPP,3 a rating of I was applied to a single recommendation for therapy, to treat symptomatic
Discussion
Current management of many posterior segment disorders, including diabetic retinopathy, age-related macular degeneration, and venous occlusive disease, is based on results of prospective randomized collaborative trials. However, our review of the ophthalmologic literature devoted to prevention of retinal detachment revealed that optimal trials regarding prophylactic treatment are unavailable. Prospective randomized trials of therapy to prevent retinal detachment have not been performed. Our
Acknowledgements
The author thanks Dennis Robertson, MD, and the additional members of the AAO PPP Retina Panel: Richard K. Bernstein, MD, FACE, FACN, Michael A. Bloom, MD, Emily Y. Chew, MD, Paul P. Lee, MD, Louis A. Lobes, MD, Flora C. Lum, MD, David W. Parke II, MD, and Marco A. Zarbin, MD, PhD.
References (14)
- O’Day DM, Steinberg EP, Dickersin K. Systematic literature review for clinical practice guideline development. Trans Am...
- Hall-Moller J, Albrecht K, Lee P. Conformance with the preferred practice pattern for diabetic eye care. Retina...
- American Academy of Ophthalmology. Management of posterior vitreous detachment, retinal breaks, and lattice...
- Wilkinson CP, Rice TA. Michels Retinal Detachment, 2nd ed. St. Louis: Mosby, 1997;1082–117....
- Shea M, Davis MD, Kamel I. Retinal breaks without detachment, treated and untreated. Mod Probl Ophthalmol...
- Robertson DM, Norton EWD. Long-term follow-up of treated retinal breaks. Am J Ophthalmol 1973;75:395–404....
- Verdaguer J, Vaisman M. Treatment of symptomatic retinal breaks. Am J Ophthalmol 1979;87:783–8....
Cited by (94)
The genetics and disease mechanisms of rhegmatogenous retinal detachment
2023, Progress in Retinal and Eye ResearchRetinal detachment after refractive lens exchange with EDOF and multifocal intraocular lenses: A narrative review
2023, Archivos de la Sociedad Espanola de OftalmologiaFellow-Eye Retinal Detachment Risk as Stratified by Hyaloid Status on OCT
2023, OphthalmologyPeripheral Retinal Degenerations and Treatment Options
2022, Advances in Ophthalmology and OptometryCitation Excerpt :Treatment of asymptomatic lattice degeneration with laser photocoagulation is not strongly supported by the current literature. In the absence of randomized control trial data, some physicians may follow anecdotal or experiential patterns of management for lattice degeneration, which may include treatment when eyes are significantly myopic, the fellow eye has a history of retinal degeneration, or there is an absence of posterior vitreous detachment before planned cataract surgery [43]. However, prior studies of eyes with more than 6 diopters of myopia or more than 6 clock-hours of degeneration did not support prophylactic treatment [43,44].
Spectral-domain optical coherence tomography of peripheral lattice degeneration of myopic eyes before and after laser photocoagulation
2019, Journal of the Formosan Medical AssociationCitation Excerpt :There was no prospective study found in the literature review regarding the prophylactic treatment of asymptomatic retinal breaks or lattice degenerations for preventing retinal detachment.19 There is no efficient evidence of effective prophylactic treatment of retinal lesions except for that with symptomatic flap tears.11 The treatment of lattice degeneration is basically observation unless further symptoms or breaks develop.