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YAG Laser
Published in Anita Prasad, Laser Techniques in Ophthalmology, 2022
Active post-operative inflammation must be treated prior to laser vitreolysis. Care must be taken in high myopes and patients with lattice degeneration, due to potential risk of retinal tears and detachment. Pre-existing CMO needs treatment with sub-tenon or peribulbar steroids.
Retinal breaks
Published in A Peyman MD Gholam, A Meffert MD Stephen, D Conway MD FACS Mandi, Chiasson Trisha, Vitreoretinal Surgical Techniques, 2019
A retinal break may be defined as any full-thickness defect in the retina. When retinal breaks occur in the presence of vitreous traction, retinal detachment may result, making identification of retinal breaks associated with vitreous traction important. In the peripheral retina, tears, holes, and dialyses are the most commonly observed retinal breaks. A flap or horseshoe tear is almost always the result of vitreous traction. The horseshoe points toward the optic disc; the vitreous is attached to the elevated flap. Round holes may be either atrophic or operculated. An operculum is a piece of retinal tissue that has been pulled free from the retina by vitreous traction and usually can be seen in the vitreous cavity over the resultant defect. Even though the operculum is free, there may still be traction around the hole. Round atrophic holes are felt to be the result of dissolution of retinal tissue, rather than the result of vitreous traction, and thus differ from operculated holes and flaps or horseshoe retinal tears (Fig. 2.1). Retinal dialyses are often the result of blunt trauma. Lattice degeneration (Fig. 2.2) is an atrophic change in the peripheral retina, often associated with both atrophic retinal holes and retinal traction.1
Molecular Anatomy of the Vertebrate Eye
Published in Marcel E. Nimni, Collagen, 1988
Lattice degeneration of the retina consists of a group of peripheral lesions that have some distinct morphological features: thinning or excavation of the retina, absence of the vitreous, condensation of the vitreous pocket combined with proliferative margins, irregular pigmentation, and branching white lines of occluded vessels.87,88 An additional feature, in many instances, is a loss of transparency of the retinal tissue within the borders of the lesion and in the immediate surroundings. This loss of transparency gives the retina a grayish-white color, called retinal sclerosis.87 The retinal sclerosis may be due to a loss of a neural tissue and its replacement by proliferating glial cells and collagenous microfibrils that are surrounded by basement membrane components. The glial cells, under pathologic conditions, may therefore be responsible for the synthesis of collagenous components88 while the sclerotic tissue may represent trapped remnants of vitreous. Retinal pigment epithelium (RPE) may also be a source of the sclerotic tissue, as pigment epithelium is seen closely related to the patches of collagenous components.
Posterior segment conditions associated with myopia and high myopia
Published in Clinical and Experimental Optometry, 2020
Divya Jagadeesh, Krupa Philip, Cathleen Fedtke, Monica Jong, Angelica Ly, Padmaja Sankaridurg
Lattice degeneration (Figure 1D) is a degenerative change of the peripheral retina characterised by linear or oval patches of retinal thinning that are circumferential and commonly located slightly anterior to the equator.2003 The condition is said to be typically associated with overlying vitreous liquefaction and vitreoretinal attachments at the edges. Other features that may be present include lattice‐like lines, alterations of retinal pigment, areas of thinning and atrophic retinal holes.2003 The exact mechanism underlying lattice degeneration remains unknown but an abnormality in the development of internal limiting membrane, choroidal abnormalities or vitreoretinal traction is considered to be some of the causes.2012 It is important to note that retinal tears can occur following traction from PVD.2018 Also, atrophic retinal holes within the lattice may cause a localised retinal detachment. It is one of the most commonly occurring peripheral retinal changes in high myopia (≥ −6.00 DS),2018 with prevalence ranging from 12 to 17-per cent in adults.2018 It was also observed in 20-per cent of high myopic (−6.00 DS to −25.00 DS) children aged ≤ 10-years.2010
Prevalence and Associations of Posterior Segment Manifestations in a Cohort of Egyptian Patients with Pathological Myopia
Published in Current Eye Research, 2019
Ayman G. Elnahry, Mohamed M. Khafagy, Soheir M. Esmat, Hassan A. Mortada
Among all types of visible peripheral retinal lesions found in high myopes, lattice degeneration is the most associated with the development of retinal holes and tears and thus retinal detachment. Lattice degeneration however was not significantly associated with retinal detachment in our study (p = .240). This might be due to the relatively small risk of retinal detachment associated with lattice degeneration which was shown by Murakami and Ohba to be about 1 in 90 in lattice degeneration with round holes.21 In our study, 2 out of 15 eyes with lattice degeneration had a retinal detachment, one of them was due to a tear along the posterior border of a lattice lesion, the other however was due to a macular hole.
Outcomes of Laser Retinopexy for Retinal Tears in Pseudophakic Eyes with Multifocal Versus Monofocal Intraocular Lenses: A Matched Cohort Study
Published in Current Eye Research, 2023
Taku Wakabayashi, Hannah E. Anderson, Annika G. Samuelson, Ava Torjani, Abtin Shahlaee, Raziyeh Mahmoudzadeh, Mirataollah Salabati, Michael A. Klufas, Yoshihiro Yonekawa
Patients in this study underwent in-office laser photocoagulation via laser indirect ophthalmoscopy after informed consent, including comprehensive discussion of the risks, benefits, and alternatives. In general, at least three rows of confluent laser burns were applied anterior and posterior to the retinal tear. Other peripheral retinal pathologies apart from retinal tears, such as lattice degeneration, were also treated at the discretion of the surgeon.