12/19/2023 0 Comments Lattice hole in retina![]() ![]() Unlike atrophic holes, operculated holes usually originate in focal areas of vitreoretinal abnormalities. Here, in (A), you can see blanching of the laser immediately after application, while in (B) a typical hyperpigmentation is noted with time. Click image to enlarge. Laser prophylaxis is noted around a single atrophic hole (previously noted in Figure 1A) and multiple holes (noted in Figure 3B). In one patient (A) the atrophic hole (blue arrows) is an isolated finding, whereas in a different patient (B) the atrophic hole (blue arrow) is associated with lattice degeneration (yellow arrow).įig. ![]() Chronic inferotemporal retinal detachments (red arrows) noted in these asymptomatic patients. Laser prophylaxis of atrophic holes may reduce the risk of retinal detachment and carries minimal to no risk ( Figure 6). 6 RRDs located in the inferior or temporal retinal quadrants, or both, are often found in completely asymptomatic patients not aware of superior or nasal field loss. Often, atrophic round holes lead to slow-growing chronic detachments ( Figure 5). 3-5 However, a full-thickness retinal hole can allow transmission of fluid from the vitreous cavity to the subretinal space and may result in subretinal fluid accumulation and a rhegmatogenous retinal detachment (RRD). There is no clear consensus for management of atrophic retinal holes therefore, many practitioners elect to monitor. Careful examination and scleral depression is needed to distinguish between full-thickness and partial-thickness retinal holes, as their management can vary. As these can be considered “partial-thickness holes,” there is no threat for chronic flux of fluid to the subretinal space. The small crevices (blue arrow) noted within patches of lattice usually represent a partial excavation of the neurosensory retina. OCT shows a full-thickness break (blue arrow) and surrounding sub-and intraretinal fluid (red arrow) in the so called “cuff of fluid.” The progression of this fluid can lead to a chronically progressive rhegmatogenous retinal detachment. Lattice degeneration with multiple retinal holes. 1,2 Often, these holes are contained within, or are adjacent to, lattice degeneration and may be partial or full thickness ( Figures 3 and 4). While atrophic holes occur secondary to focal degeneration of the neurosensory retina and are not resultant from vitreous traction, they can exhibit surrounding areas of abnormal vitreoretinal adhesion ( Figure 2). Most patients exhibiting these have no associated symptoms. These are most often found during routine exam of the peripheral retina ( Figure 1). The above images display atrophic retinal holes (blue arrows) with surrounding regions of vitreoretinal adhesion (red arrows) visible in the images above and below. (C) A large atrophic hole noted in routine examination and subsequently treated with laser. The ring of pigmentation (blue arrows) is a reactive repair due to separation of neurosensory retina and the retinal pigment epithelium. Atrophic retinal hole (red arrows) noted both on (A) fundus photograph and (B) OCT. ![]() What follows is a pictorial, instructive guide depicting and describing various types of retinal holes and tears, their possible etiologies and management strategies.įig. Retinal defects come in different shapes and sizes and may be either partial or full thickness. Retinal holes and tears are commonly encountered during dilated fundus examination of both symptomatic and asymptomatic patients. ![]()
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