Yi-Ting Hsieh1, Chung-May Yang2,3. 1. Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan. 2. Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan. chungmay@ntu.edu.tw. 3. College of Medicine, National Taiwan University, Taipei, Taiwan. chungmay@ntu.edu.tw.
Abstract
PURPOSE: To describe the characteristics of a novel type of retinal detachment (RD) due to paravascular abnormalities (PVAs) associated breaks in highly myopic eyes. METHODS: We retrospective recruited eight eyes with RD due to PVA-associated breaks. The clinical features and surgical results were evaluated. RESULTS: All eyes were highly myopic with a mean axial length of 31.31 ± 2.86 mm (27.51-36.52 mm). Two of the eight eyes had multiple paravascular retinal breaks associated with PVAs, four had a single paravascular break with PVAs nearby, and two had multiple paravascular breaks along the same vessels. All breaks were round or oval-shaped, and only three eyes (37.5%) had their breaks located over patchy chorioretinal atrophy. Two of the eight eyes had the breaks outside the arcades, five had their breaks within the arcades, and one had a break within the arcade as well as breaks outside the arcade. Vitrectomy and epiretinal and internal limiting membrane peeling were performed in all cases, with inverted or free internal limiting membrane flap insertions for the perifoveal breaks and endolaser for the more peripheral breaks. All eyes had retinal reattachment after one single operation. CONCLUSION: RD due to PVA-associated breaks represented a distinct entity. PVAs and the associated breaks should be searched in RD without macular hole or obvious breaks in highly myopic eyes. It may be treated as RD caused by peripheral breaks or as macular hole associated RD depending on the location of the breaks.
PURPOSE: To describe the characteristics of a novel type of retinal detachment (RD) due to paravascular abnormalities (PVAs) associated breaks in highly myopic eyes. METHODS: We retrospective recruited eight eyes with RD due to PVA-associated breaks. The clinical features and surgical results were evaluated. RESULTS: All eyes were highly myopic with a mean axial length of 31.31 ± 2.86 mm (27.51-36.52 mm). Two of the eight eyes had multiple paravascular retinal breaks associated with PVAs, four had a single paravascular break with PVAs nearby, and two had multiple paravascular breaks along the same vessels. All breaks were round or oval-shaped, and only three eyes (37.5%) had their breaks located over patchy chorioretinal atrophy. Two of the eight eyes had the breaks outside the arcades, five had their breaks within the arcades, and one had a break within the arcade as well as breaks outside the arcade. Vitrectomy and epiretinal and internal limiting membrane peeling were performed in all cases, with inverted or free internal limiting membrane flap insertions for the perifoveal breaks and endolaser for the more peripheral breaks. All eyes had retinal reattachment after one single operation. CONCLUSION: RD due to PVA-associated breaks represented a distinct entity. PVAs and the associated breaks should be searched in RD without macular hole or obvious breaks in highly myopic eyes. It may be treated as RD caused by peripheral breaks or as macular hole associated RD depending on the location of the breaks.