J Korean Ophthalmol Soc.  2011 Apr;52(4):448-453.

Comparison between Retinal Tear and Rhegmatogenous Retinal Detachment as the Cause of Dense Vitreous Hemorrhage

• Shin KH
• Nam DH
• Lee DY

Abstract

PURPOSE
To analyze retinal tears and to compare the clinical outcomes between retinal tear and rhegmatogenous retinal detachment (RRD) as the cause of dense non-diabetic vitreous hemorrhage in patients who underwent vitreoretinal surgery.
METHODS
In a retrospective case series, the medical records of patients who presented dense non-diabetic vitreous hemorrhage and who underwent vitreoretinal surgery between January 2005 and June 2009 were reviewed. Among the 134 patients, 27 patients had dense vitreous hemorrhage caused by retinal tears. The first group had retinal tears only and the second group had accompanying RRD. A comparison of clinical features and postoperative prognoses between the two groups was performed.
RESULTS
Among the 27 eyes with non-traumatic retinal tear and RRD, 18 were categorized into the retinal tear group and 9 to the RRD group. The demographic findings between the two studied groups exhibited no significant differences except for time between onset of symptoms and diagnosis. However, the time to diagnosis was significantly delayed in the group with RRD (22.67 +/- 37.47 days) compared to the retinal tear group (5.00 +/- 3.41 days) (p = 0.035). The amount of visual improvement was also greater in the retinal tear group than the RRD group (p = 0.002).
CONCLUSIONS
Retinal tears are a major cause of non-diabetic vitreous hemorrhage. Vitreous hemorrhage caused by retinal detachment may result in delayed diagnosis and poor visual recovery. Therefore, early examinations in suspicion of RRD and appropriate treatments are needed in non-diabetic vitreous hemorrhage.

Keyword

Non-diabetic vitreous hemorrhage; Retinal tear; Rhegmatogenous retinal detachment

MeSH Terms

Delayed Diagnosis
Eye
Humans
Medical Records
Prognosis
Retinal Detachment
Retinal Perforations
Retinaldehyde
Retrospective Studies
Vitreoretinal Surgery
Vitreous Hemorrhage
Retinaldehyde

Figure

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  Figure 1. (A) Transverse echogram shows echo-genic retinal ridges adherent to the posterior vitreous cortex that were interpreted as suspicious retinal tears, but no retinal tears could be confirmed by indirect ophthalmoscopy. (B) Vertical echograms. (C) Vertical echograms shows dense vitreous hemorrhage.

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  Figure 2. Change of preoperative and postoperative mean visual acuity. * Statistically significant; † Wilcoxon matched-pairs signed-ranks test; ‡ Mann-whitney U test.

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  Figure 3. Distribution of retinal tears.

Reference

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