Ординатура / Офтальмология / Английские материалы / Illustrated Tutorials in Ophthalmology Kanski, Bolton 2001
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Typical lattice degeneration
•Present in about 8% of general population
•Present in about 40% of eyes with RD
Retina |
Vitreous |
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Spindle-shaped islands of retinal thinning |
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Overlying vitreous liquefaction |
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Network of white lines within islands |
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Exaggerated attachments |
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Variable associated RPE changes |
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around margin of lesion |
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Small round holes within lesions are common |
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Complications of lattice degeneration
•No complications - in most cases
•RD associated with atropic holes, particularly in young myopes
•RD associated with tractional tears in eyes with acute PVD
Indications for prophylaxis
•RD in fellow eye
•Extensive lattice in high myopia
Snailtrack degeneration
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Sharply demarcated, frost-like bands |
Large round holes which carry |
which are longer than lattice |
high risk of RD |
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Indications for prophylaxis - presence of holes
White-without-pressure
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Translucent grey appearance of retina |
Occasional giant tear formation along |
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posterior margin of lesion |
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Indications for prophylaxis - giant tear in other eye
Benign peripheral retinal degenerations
PRINCIPLES OF RETINAL DETACHMENT SURGERY
1.Scleral buckling
•Configuration of buckles
•Preliminary steps
•Localization of breaks
•Cryotherapy
•Insertion of local explant
•Encircling procedure
•Drainage of subretinal fluid
•Causes of early failure
2.Pneumatic retinopexy
3.Vitrectomy
•Giant tears
•Proliferative vitreoretinopathy (PVR)
•Diabetic tractional RD
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