|Year : 1979 | Volume
| Issue : 2 | Page : 42-44
A study of peripheral retina in myopes with aphakia
Subhash Sharma, YC Mishra, Neh Lata
Department of Ophthalmology, S.P. Medical College, Bikaner, India
Department of Ophthalmology, S.P. Medical College, Bikaner
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sharma S, Mishra Y C, Lata N. A study of peripheral retina in myopes with aphakia. Indian J Ophthalmol 1979;27:42-4
|How to cite this URL:|
Sharma S, Mishra Y C, Lata N. A study of peripheral retina in myopes with aphakia. Indian J Ophthalmol [serial online] 1979 [cited 2021 Mar 6];27:42-4. Available from: https://www.ijo.in/text.asp?1979/27/2/42/31238
The peripheral fundus is defined as the area of the fundus anterior to the scleral entrances of the vortex veins. It is sub-divided into the equatorial and an oral regions. This study was undertaken in order to establish the prevalance of various degenerative changes at the peripheral retina in myopes with aphakia, with particular emphasis on those changes which might lead to the development of retinal detachment.
| Material and Methods|| |
Eighty eyes of fifty patients with myopia of 4-8 diopter operated for cataract, were examined in the out-patient department of Prince Bijay Singh Memorial Hospital, attached to the Sardar Patel Medical College, Bikaner. This study was performed from 1976 to 1980.
30 eyes were examined within 2-3 months of cataract extraction, 12 eyes were examined between 3-12 months after cataract extraction and 8 eyes were examined 1-2 years after cataract extraction. Of the 50 patients, there were 39 males and 11 females (Table 1). Four patients were between 39-49 years of age, 56 were aged 50.60 years, 10 were aged 61 to 70 years. The fundus was examined after full pupillary dilation by instillation of homatropine drops 1% and phenylephrine hydrochloride 10%. Indirect ophthalmoscopy was performed with Schepens indirect ophthalmoscope and scleral depressor.
Examination of the fundus periphery could not be complete in other 20 eyes because of hypersensitivity to the bright light of the ophthalmoscope, hazy media, or insufficient pupillary dilatation, and were not included in the present study.
| Results|| |
Retinal Breaks: There were 13 full thickness retinal breaks in 10 eyes out of 80 eyes examined (16.2%) including 3 horseshoe and 10 round breaks. Nine of the breaks were in the equatorial region of the peripheral retina, i.e., more than 2 disc diameter from the ora serrata and 11 were in the ora region. There were 7 breaks in the upper temporal, 3 in lower temporal, 2 in upper nasal and 1 in lower nasal.
Nine breaks were upto one quarter disc diameter in size, two were one-half disc diameter, one was one disc diameter and one was larger than one disc diameter. Retinal breaks were present in two of the four eyes in which vitreous loss had occurred during cataract extraction. There was no significant correlation between the prevalance of retinal break and age.
Peripheral retinal haemorrhage: Small round retinal haemorrhage in a row parallel to the ora serrata, were found in the peripheral retina of 8 eyes, they were more frequently in the lower quadrant and in the temporal than in the nasal quadrants [Table - 2]
Lattice degeneration: This was found in 3 eyes more in the upper temporal quadrant [Table - 2].
Snail track degeneration: This is often regarded as an early form of lattice. It was found in 7 quadrants of 3 eyes and was equally distributed throughout the four quadrants [Table - 2].
Cystoid degeneration: Some cystoid degeneration was found in almost every eye examined and marked cystoid degeneration was present in 63 quadrants of 20 eyes. It was more frequently in the upper than in the lower half of the retina.
Retinoschiasis: It was present in 6 quadrants of 9 eyes
Paring stone degeneration: It was present in 16 quadrants of 10 eyes.
Pigmentary degeneration: It was present in 71 quadrants, more frequently in the upper than in the lower quadrants of the peripheral retina.
| Discussion|| |
A comparison of the results of the present study with the relevant reports in the literature reveals that retinal breaks and other degenerative lesions of the peripheral retina are found frequently in eye prone to retinal detachment. Hyams & Newmann reported breaks in 11.1% of myopic eyes as compared to 9% of emmetropic-aphakic eyes reported by Friedman, Newmonn. and Hymas. In the present study 10 out of 80 aphakic eyes with myopia of 4-8 diopters had 13 full thickness retinal breaks (16.2%) as compared to 18.4% in 19 out of 103 aphakic eyes reported by Hyams, Newmann and Friedman. The prevalance of lattice, snail track, pigmentary, paving stone and cystoid degeneration in the myopes with aphakia in the present series was similar to the prevalance of these lesions in myopes with aphakia reported by Hyams, et al and in phakic-myopic eyes reported by Hyams and Newmann. Attempts to prevent retinal detachment are based largely upon the prophylactic treatment of retinal breaks. Hyams, Bialik and Newmann emphasised that atleast 6.7% of eyes with high myopia will develop retinal detachment after extraction of the cataract so that one would be justified in treating breaks in such eyes on assumption that approximately 1/3 of them will cause a detachment. However, recent studies suggest that most detachment are caused by fresh, as opposed to established retinal breaks, in which case the high prevalance of retinal breaks in aphakic eyes with high myopia is simply a reflection of the tendency of such eyes to develop both breaks and detachment.
| Summary|| |
A study of peripheral retinal lesions was carried out in 80 eyes of 50 patients with myopia of 4-8 diopters prior to cataract extraction. Retinal breaks were found in 10 eyes (16.2%). The high prevalance of retinal breaks in aphakic eyes with high myopia is compatible with the high incidence of retinal detachment in such eyes.
| References|| |
Friedmann, Z., Newmann, E., and Hyams, S. (1973). Brit. J. Ophthal., 57, 52
Hyams, S., and Newmann, E. (1969). Brit. J. Ophthal., 53, 300.
Hyams, S., Meir, E., Ivry, M., Krakowski, D., Baskai, S., Jedwab, E., and Newmann, E. (1964). Amer. J. Ophthal., 78, 429.
S.W. Ayams, E. Newmann and Z. Friedman (1975). Brit. J. Ophthal., 59,483.
S. Hyams, M. Bialik and E. Newmann (1975). Brit. J. Ophthal., 59, 480.
Newmann, E. and Hyams, S. (1972). Brit. J. Ophthal., 56, 482.
Rutin, U. (1967). Amer. J. Ophthal., 64, 821.
[Table - 1], [Table - 2]