![]() ![]() With additional traction, a horseshoe tear (flap tear) develops. Mild traction causes tenting of the retina. The PVD may produce retinal breaks in areas of firm vitreoretinal attachments and on narrow posterior extensions of the vitreous base. However, when the separating vitreous remains firmly adherent to an area of the retina, localized vitreoretinal traction results. This event is the result of vitreous syneresis (liquefaction). PVD occurs when the posterior vitreous separates from the retina and collapses anteriorly toward the vitreous base. Posterior vitreous detachment is the critical event leading to the development of retinal tears and retinal detachment. In this article, we will examine some of the conditions that put patients at risk for retinal detachment and the indications and potential benefits of prophylactic treatment. The management of these lesions is based on an increased understanding of their natural history and the potential for complications associated with treatment. ![]() Precursors to RD include posterior vitreous detachment, symptomatic retinal breaks, asymptomatic retinal breaks, lattice degeneration, and other less common vitreoretinal abnormalities. Retinal detachment occurs with a frequency of 1/10,000 people per year, 1 and patients at risk for RD include those with myopia, aphakia, trauma, RD in the fellow eye, a family history of RD, certain systemic syndromes, and a variety of peripheral retinal lesions. RETINAL SURGEONS DIFFER IN THEIR APPROACH to prophylactic treatment of vitreoretinal abnormalities. ![]()
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