|Year : 1982 | Volume
| Issue : 6 | Page : 555-559
Fellow eyes of retinal detachment cases
OP Ahuja, Manoj Shukla
A.M.U. Institute of Ophthalmology, J.N. Medical College, Aligarh, India
O P Ahuja
A.M.U. Institute of Ophthalmology, J.N. Medical College, Aligarh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Ahuja O P, Shukla M. Fellow eyes of retinal detachment cases. Indian J Ophthalmol 1982;30:555-9
This paper deals with our observations in fellow eyes of rhegmatogenous retinal detachment cases seen at our `Retina service'.
| Materials and methods|| |
The present report includes our observations in 265 fellow eyes of 300 rhegmatogenous retinal detachment cases. 35 fellow eyes could not be examined due to poor or no visibility of retina on account of corneal opacity, cataract, posterior synaechia, phthisis bulbi and similar conditions. In 23 cases, retinal detachment was bilateral out of which those having a later onset of retinal detachment were considered as fellow eyes.
The peripheral retina was examined after a maximal pupillary dilatation in a darkened room with Fison's indirect ophthalmoscope. If required this was supplemented by posterior segment biomicroscopy with the help of Goldmann's 3-Mirror contact lens. The findings were recorded on a conventional fundus chart.
| Observations|| |
142 (53.59%) out of 265 fellow eyes studied revealed peripheral degenerative lesions The various lesions observed have been shown in [Table - 1]. The individual lesions were present either alone or concurrently with one or more other types.
Piementarv degeneration was seen in the form of localised pigment clumping or diffuse pigmentation in 18 (6.79%) eyes. In 5 eyes, it was seen alround the equator (360°). Significantly 11 (61.11%) of the affected eyes had a myopia of more than 30. No retinal break was observed in these eyes, although some of the pigment clumps were oriented in a horse shoe form [Figure - 1].
Paving stone degeneration was seen in 28 (10.19%) eyes, Majority of these eyes (22 eyes, 78.57%) were myopic. A total number of 162 patches of paving stone degeneration were observed at an average of 5.78 patch per eye, being present generally in one or in two tiers in the suboral and equatorial locations. Nearly three fourths of islands were present In the infero-temporal quadrant (120 eyes, 74.07%). Mild to severe peripheral chorioretsnal degeneration was seen in 36 (13. 58%) eyes, more than half of the affected eyes being myopic (20 eyes, 55.56%). Interestingly, the eyes with higher grades of cystoid degeneration had none or mild chorioretinal degeneration. and visa versa [Figure - 1]
Lattice degeneration was the commonest lesion observed in 43 (16.23%) eyes, 15(34.88% of these sharing a bilateral involvment, The degeneration was present in one to four tiers, most commonly located at the equator. In as many as 17 (39.54%) eyes the degeneration was present alround (240-360°). 28(65.12%) out of 43 eyes were myopic. having a myopia of more than 3D. There was a total of 258 patches at an average of six per eye. Significantly, a large majority of these patches were seen in the temporal retina specially the superotemporal quadrant [Table - 2]
84 retinal breaks, mostly in the form of round holes were seen in 16 (37.21%) eyes having lattice degeneration [Table - 3], Characteristically these holes were seen in the substance of lattice islands while the horse shoe tears were located at their posterior margins [Figure - 1]. In one eye having 360° lattice degeneration as many as 15 round holes were present.
Majority of the retinal breaks seen in relation with lattice degeneration were present in the supero-temporal quadrant [Table - 3]. Lattice degeneration was the causative factor for bilateral retinal detachment in 7 out of 23 cases.
Snail track degeneration [Figure - 1] was seen in 12(4.53%) eyes, all the affected eyes having a myopia of more thin 3 D. A total of 17 patches were seen located most commonly in the equatorial region of the supero-temporal retina In 4 of these eyes, the degeneration was seen along with lattice degeneration. 4 partial thickness round holes were associated with snail track lesions in 2 eyes.
The phenomenon of white with pressure (WWP) and white without pressure (WWOP) was seen in 46 (17.35%) eyes. A total of 44 islands of WWP were observed, all being suboral in location. Temporal periphery in myopic eyes having a myopia of more than 3D was more commonly involved. White without pressure (WWOP) lesions were seen in six eyes, all eyes being myopic (-4.OODsph to-16 Dsph). In 3 eyes, the lesion extended alround while in rest it was limited to supero-temporal and infero-temporal quadrants No hole or tear was seen in areas of WWP and W WOP.
Different types [Table - 4] of 97 retinal breaks were observed in 31(11.70%) eyes. Out of these, 41 breaks were related to retinal detachment in 20 eyes. Mere than half of the retinal breaks were present in the superotemporal quadrant [Table - 5].
| Summary|| |
26 fellow eyes of 300 rhegmatogenous retinal detachment cases were studied to find out various degenerative lesions of the peripheral retina. 142(53.59%) out of 265 eyes examined had demonstrable lesions of various types. Lattice degeneration of retina was the commonest cause for retinal break formation. Retinal detachment was seen in 23(8.68.%) fellow eyes. Follow up of fellow eyes should be a must in view of their predisposition to retinal detachment.
[Figure - 1]
[Table - 1], [Table - 2], [Table - 3], [Table - 4], [Table - 5]