Title

GIANT RETINAL TEAR: CASE SERIES

Introduction

Giant retinal tear (GRT) is a pathological condition that requires immediate action when diagnosed due to the possibility of quickly leading to extensive retinal detachment (RD). It is classified as GRT when retinal breaks extend greater than 90° or more in the presence of posterior vitreous detachment(1,2). It is known that GRT increases the risk of developing proliferative vitreoretinopathy and frequently affects the fellow eye(1). For this reason, it is important to investigate the cause in order to prevent bilateral involvement and other complications.

Methods

Medical records review

Results

We report two cases of GRT greater than 150°. Both were middle aged woman complaining of floaters and visual acuity loss from 7 to 30 days before. Best visual acuity (BVA) was counting fingers in both cases. In one of them, the patient had myopia and fundoscopy showed proliferative vitreoretinopathy (PVR) at diagnose. In the other one, lattice degeneration was seen fundoscopically and there was vitreous hemorrhage and macula-off at diagnose. None of them developed hypotony. In both cases pars plana vitrectomy was performed, perfluorocarbon liquid was introduced to retina attachment and endophotocoagulation was executed. However, the second one was preceded by phacoemulsification, placement of intraocular lens and encircling scleral band 360°.

Discussion

GRT represents about 1,5% of the cases of full RD(2). Visual acuity is quite reduced and in cases of macula-off it can vary between counting fingers and light perception(1). The presence of GRT should alert the ophthalmologist to prevent rapidly extensive RD and fellow eye involvement. It is known that in 29 to 43% of the cases RD occurs in the fellow eye and GRT in 12.8% of the cases (2). In the lattice degeneration case reported, the patient’s fellow eye had already been affected by retinal detachment 2 years before. Therefore, it is important not only to recognize the GRT condition and conduce proper treatment as well as prevent fellow eye involvement.

Keywords

- Giant retinal tear - Detachment - Retina - Vitrectomy

Area

SURGICAL CASE

Authors

Gabriella Marranghello Mingione, Paulo Henrique Horizonte, Nathalia Nishiyama Tondelli, Fernanda Salata Antunes, Walther Oliveira Campos Neto, Farid José Thomaz Neto, Nina Rosa Konichi Silva, André Marcelo V. Gomes