Medical hypothesis, discovery & innovation in optometry

Topographic correspondence of peripheral retinal lesions between the fellow eyes of patients with rhegmatogenous retinal detachment and retinal break

Medical hypothesis, discovery & innovation in optometry, Vol. 4 No. 2 (2023), 22 June 2023 , Page 57-62
https://doi.org/10.51329/mehdioptometry174

Abstract

Background: In rhegmatogenous retinal detachment (RRD), the risk of fellow eye involvement varies from 5% to 34% according to the follow-up duration and criteria used for patient selection. The aim of the present study was to investigate the frequency, characteristics, and predisposing factors for symmetric lesions in the fellow eyes of patients with RRD or retinal breaks.
Methods: This case series included consecutive patients with recent-onset RRDs or retinal breaks. Eyes with traumatic breaks or RRD, grade C proliferative vitreoretinopathy, extensive (more than 6 h) lattice degeneration, a history of RRD surgery or pars plana vitrectomy in the fellow eye, or concomitant retinal pathologies, such as diabetic retinopathy, macular neovascularization, uveitis, or glaucoma, were excluded. Demographic data, best-corrected distance visual acuity, refraction, break characteristics, and expansion of the retinal detachment were recorded.
Results: Of the 68 participants, with a mean (standard deviation) age of 48 (12.1) years, 54 (79.4%) were men, and 14 (20.6%) were women. Of the 68 primary eyes, 60 (88.2%) had RRDs, and eight (11.8%) had retinal breaks. Horseshoe tears were the main lesion in 41 (68.3 %) primary eyes with RRD. Symmetric lesions were observed in 37 (54.4%) fellow eyes, including retinal breaks in 16 (43.2%) and lattice degeneration without breaks in 21 (56.8%) eyes. Lattice degeneration and multiple breaks were observed in 15 of 28 (53.6%) primary eyes with a lattice, whereas only seven of 40 (17.5%) lattice-free primary eyes had multiple breaks (P = 0.002). A multiple logistic regression model revealed that the presence of lattice degeneration in the primary eye (odds ratio, 26.91; 95% confidence interval, 4.18 – 173.20; P < 0.001) was the only factor predicting symmetricity in the fellow eye.
Conclusions: More than half of the patients with RRD or retinal breaks in the primary eye harbored symmetrical retinal lesions in their fellow eyes. This emphasizes the importance of regular examination of the fellow eyes with a greater focus on symmetric positions in the fellow eye. The presence of a lattice in the primary eye was the only predictor of symmetry in the contralateral eye. Further longitudinal studies with larger populations are required to determine the significance of these symmetric lesions in the fellow eyes of patients with RRD and the value of prophylactic treatment.
Keywords:
  • rhegmatogenous retinal detachment
  • retinal detachments
  • retinal break
  • retinal hole
  • retinal tear
  • preventive therapy
  • odds ratios

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