Symptoms related to posterior vitreous detachment and the risk of developing retinal tears: a systematic review

Abstract

Flashes and floaters are the hallmark symptoms of a posterior vitreous detachment (PVD) which itself is related to an increased risk of the development of retinal tears, retinal detachment and vitreous haemorrhage. The aim of this study is to assess the associations between different symptoms related to PVD and the risk of developing retinal tears. A systematic review of articles written in English, using MEDLINE, Embase (via Embase.com) and the Cochrane Controlled Trials Register (1996–2017) was conducted. Search terms included five elements: PVD, retinal tears, retinal detachment, floaters and flashes. Independent extraction of articles was conducted by two authors using predefined data fields, including study quality indicators. Thirteen studies fulfilled the selection criteria. Analysis of pooled data revealed that presence of isolated flashes was associated with the development of retinal tears in 5.3% of symptomatic eyes [mean 2.9 eyes; 95% CI (2.1, 5.7)].Conversely, floaters alone had a stronger association with retinal tears (16.5% of eyes), as compared to flashes. The association to retinal tears was even greater for those patients reporting both flashes and floaters [mean 17.8 eyes (20.0%); 95% CI (17.4, 18.1)]. Retinal and/or vitreous haemorrhage was also associated with the presence and later development of retinal tears [mean 12.5 eyes (30.0%); 95% CI (11.7, 13.9)]. Patients with more than 10 floaters or a cloud in their vision had a high risk of developing retinal tears (OR19.8, p‐value 0.032). In the setting of a PVD, the onset of flashes and floaters, and the presence of retinal and/or vitreous haemorrhage are risk factors for the development of retinal tears. The association is greater when both symptoms are present, and even greater when the patient reports more than 10 floaters, a curtain or a cloud and/or there is a positive finding of a vitreous or retinal haemorrhage. This study supports the necessity of an immediate examination of patients presenting with symptoms related to a PVD, and a follow‐up examination might be prudent in a subgroup of these patients.

Amotio-retinae-Versorgung während der Corona-Pandemie

“…Eine Amotio retinae ist ein ophthalmologischer Notfall und führt unbehandelt zu einem progredienten Visusverlust [ 7 , 10 , 16 , 21 , 24 ]. Die häufigste Form ist dabei eine rhegmatogene Amotio retinae.…”

Posterior Vitreous Detachment in Highly Myopic Patients

“…P osterior vitreous detachment (PVD) is associated with serious ocular pathologies, including retinal tears, rhegmatogenous retinal detachment, vitreous hemorrhage, macular holes, and macular traction syndrome. [1][2][3][4][5][6][7][8] These PVD-related retinal pathologies occur more frequently in patients with high myopia than in patients without high myopia. [9][10][11][12][13][14][15][16] Accordingly, it is assumed that the progression of PVD also differs between highly myopic eyes and nonhighly myopic eyes.…”

Retinal tear and posterior vitreous detachment following repetitive transcranial magnetic stimulation for major depression: A case report

“…However, certain risk factors, including trauma, can result in an earlier development of PVD. The most frequent symptoms related with acute PVD are floaters and photopsias [6,7]. During the evolution of a PVD, the vitreous may cause traction on certain areas of the retina, which can result in a retinal tear [7].…”

“…The most frequent symptoms related with acute PVD are floaters and photopsias [6,7]. During the evolution of a PVD, the vitreous may cause traction on certain areas of the retina, which can result in a retinal tear [7]. Symptomatic retinal tears require prompt treatment as these can lead to retinal detachments [7,8].…”

“…All other patients should be counselled to advise their physician if they experience an increase in floaters, flashes of light, a visual field defect or a reduction in central vision during or after the initiation of rTMS therapy. If new symptoms occur while a patient is under treatment, rTMS should be withheld pending ophthalmological examination [7]. In the event that the patient develops a retinal tear or retinal detachment attributed to rTMS, it may be advisable to discontinue future treatment.…”