Symptoms Predictive for the Later Development of Retinal Breaks

Overdam, Koen A van; Bettink-Remeijer, Marijke Wefers; Mulder, Paul; Meurs, Jan van

doi:10.1001/archopht.119.10.1483

Cited by 47 publications

(46 citation statements)

References 10 publications

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“…The patient may have developed an RRD prior to this scheduled visit, and found no reasons to consult the RO earlier. van Overdam et al 12,13 found that 5% of patients developed a new retinal tear after the initial examination. In this study, 3% (n ¼ 6) of patients (two from the RO and four from our center) developed an RRD after the initial examination when only a PVD, without a retinal tear, was diagnosed.…”

Section: Discussionmentioning

confidence: 99%

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Patient ignorance is the main reason for treatment delay in primary rhegmatogenous retinal detachment in The Netherlands

Goezinne

Heij

Berendschot

et al. 2008

Eye

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Section: Discussionmentioning

confidence: 99%

“…Nevertheless, PVD is associated with an Treatment delay in retinal detachment F Goezinne et al increased risk for the development of retinal tears. 12 Retinal tears have been reported in 7.3-14% of patients with a PVD. 6 Although an RRD may be present or may develop after a PVD, subjective flashes and/or floaters can be absent.…”

Section: Discussionmentioning

confidence: 99%

Patient ignorance is the main reason for treatment delay in primary rhegmatogenous retinal detachment in The Netherlands

Goezinne

Heij

Berendschot

et al. 2008

Eye

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“…Photopsias caused by vitreoretinal traction are an ominous sign of a retinal tear, particularly when associated with the appearance of multiple floaters [57,58,59]. Photopsias in this context are often reported as lightning streaks, vertical or oblique.…”

Section: Posterior Vitreous Detachmentmentioning

confidence: 99%

The Vitreous, the Retinal Interface in Ocular Health and Disease

2013

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The vitreous is a complex structure whose composition and appearance change with age. Anomalous adhesions between the posterior vitreous face and the retinal surface are the cause of numerous vitreoretinal complications, while the presence of an intact posterior hyaloid provides a scaffold for vascular growth and anteroposterior traction. This review summarizes what is known about the biochemistry of the vitreous, the process of posterior vitreous detachment (PVD) development, and the available clinical approaches to examining the vitreous and its interface. A pooled analysis of studies looking at the presence of a complete, partial or absent PVD in a number of macular and retinal diseases allows us to establish odds ratios for these various states. From this emerge both protective and disease-associated states in conditions such as proliferative diabetic retinopathy, macular edema, and age-related macular degeneration. With the emergence of pharmacological means to separate the posterior hyaloid, a better understanding of the possible role of the vitreous in tractional syndromes is required.

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“…About one sixth of these patients may have a retinal break at the initial examination. [1][2][3][4][5][6][7][8][9][10] The remainder will be reexamined usually 6 to 8 weeks after the onset of symptoms, but a new retinal break will develop in only a few patients in this time frame. [1][2][3][4][5] These reexaminations claim considerable time and manpower of the ophthalmic casualty department, as each visit requires a detailed dilated fundus examination.…”

mentioning

confidence: 99%

“…In a previous prospective study, 1 we used a standardized and detailed historytaking form to isolate specific symptoms at the initial examination that may predict the later development of retinal breaks to allow more efficient use of ophthalmic resources by safely discharging patients not at risk from further follow-up visits. In that study in which patients with retinal or vitreous hemorrhages were scheduled for a reexamination after 2 weeks and patients without hemorrhages for a reexamination after 6 weeks, we concluded that only patients who mention symptoms of light flashes in combination with multiple floaters or a cloud or curtain at the initial examination should be reexamined within 6 weeks.…”

mentioning

confidence: 99%

Symptoms and Findings Predictive for the Development of New Retinal Breaks

Overdam¹

2005

Arch Ophthalmol

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To validate the conclusion of our previous prospective study of 250 patients with isolated posterior vitreous detachment: follow-up visits are only necessary if patients mention symptoms of flashes in combination with multiple floaters or a curtain or cloud at the initial examination, or an increase in number of floaters after the initial examination.Methods: Prospective study of 270 consecutive patients with symptomatic isolated posterior vitreous detachment. All patients completed a questionnaire detailing their symptoms and had a full eye examination at the initial examination and at follow-up visits. Logistic regression with backward elimination was used for statistical analysis. We also performed pooled analysis of our previous and present study data.Results: New retinal breaks developed in 10 patients (3.7%). Multiple floaters, a curtain or cloud, hemorrhages (retinal or vitreous) at the initial examination, and an increase in the number of floaters after the initial examination were found to be predictive factors for the development of new retinal breaks. These factors were also the only significant predictors after pooled analysis of both studies (520 patients, 23 breaks).Conclusions: We assume we can formulate a safe policy for scheduling patients with isolated posterior vitreous detachment: only patients with multiple floaters, a curtain or cloud, or hemorrhages (retinal or vitreous) at the initial examination should be scheduled for reexamination. All other patients should return only if the number of floaters increases.

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Symptoms Predictive for the Later Development of Retinal Breaks

Abstract: To identify symptoms in patients with isolated posterior vitreous detachment predictive for the later development of retinal breaks.

Cited by 47 publications

References 10 publications

Patient ignorance is the main reason for treatment delay in primary rhegmatogenous retinal detachment in The Netherlands

Patient ignorance is the main reason for treatment delay in primary rhegmatogenous retinal detachment in The Netherlands

The Vitreous, the Retinal Interface in Ocular Health and Disease

Symptoms and Findings Predictive for the Development of New Retinal Breaks

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