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Peripheral retinal degenerations and the risk of retinal detachment

  • Hilel Lewis
    Correspondence
    Inquiries to Hilel Lewis, MD, Cole Eye Institute, The Cleveland Clinic Foundation, 9500 Euclid Avenue, i-30, Cleveland, OH, USA 44195; fax: (216) 445-7654
    Affiliations
    Cole Eye Institute, Division of Ophthalmology, The Cleveland Clinic Foundation, Cleveland, Ohio, USA
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      Abstract

      Purpose

      To review the degenerative diseases of the peripheral retina in relationship with the risk to develop a rhegmatogenous retinal detachment and to present recommendations for use in eyes at increased risk of developing a retinal detachment.

      Design

      Focused literature review and author’s clinical experience.

      Results

      Retinal degenerations are common lesions involving the peripheral retina, and most of them are clinically insignificant. Lattice degeneration, degenerative retinoschisis, cystic retinal tufts, and, rarely, zonular traction tufts, can result in a rhegmatogenous retinal detachment. Therefore, these lesions have been considered for prophylactic therapy; however, adequate studies have not been performed to date.

      Conclusions

      Well-designed, prospective, randomized clinical studies are necessary to determine the benefit-risk ratio of prophylactic treatment. In the meantime, the evidence available suggests that most of the peripheral retinal degenerations should not be treated except in rare, high-risk situations.
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