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

Kwang Hoon Shin; Dong Heun Nam; Dae Yeong Lee

doi:10.3341/JKOS.2011.52.4.448

Journal List > J Korean Ophthalmol Soc > v.52(4) > 1009015

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Shin, Nam, and Lee: Comparison between Retinal Tear and Rhegmatogenous Retinal Detachment as the Cause of Dense Vitreous Hemorrhage

Original Article

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

Published online: 6 September 2011

DOI: https://doi.org/10.3341/JKOS.2011.52.4.448

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

Kwang Hoon Shin, M.D., Dong Heun Nam, MD, PhD, Dae Yeong Lee, M.D.

Department of Ophthalmology, Gachon University of Medicine and Science, Incheon, Korea

Address reprint requests to Dae Yeong Lee, MD Department of Ophthalmology, Gachon University Gil Hospital #1198 Guwol-dong, Namdong-gu, Incheon 405-760, Korea Tel: 82-32-460-3364, Fax: 82-32-460-3358, E-mail: ldy90@hanmail.net

Received 28 April 201024 December 2010 Accepted 18 March 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Non-diabetic vitreous hemorrhage, Retinal tear, Rhegmatogenous retinal detachment

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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.

Figure 2.

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

Figure 3.

Distribution of retinal tears.

Table 1.

Distribution of patients

	Retinal tear group	Rhegmatogenous retinal detachment group	p-value	Total patients
Number of patients	18	9		27
Age (mean ± SD, yr)	53.89 ± 11.23	48.56 ± 14.58	0.253^†	52.11 ± 12.43
Sex (male:female)	6:12	6:3	0.127^‡	12:15
Laterality (right:left)	10:8	4:5	0.695^‡	14:13
Preoperative V/A (mean ± SD, logMAR)	1.51 ± 1.03	1.74 ± 1.08	0.860^†	1.59 ± 1.03
Preoperative IOP (mean ± SD, mmHg)	12.61 ± 1.88	10.44 ± 2.79	0.067^†	11.89 ± 2.41
Symptoms → Visit (mean ± SD, day)	5.00 ± 3.41	22.67 ± 37.47	0.035^†^*	10.89 ± 22.62
Visit → Surgery (mean ± SD, day)	3.89 ± 4.14	2.22 ± 0.67	0.668^†	3.33 ± 3.46
Follow up (mean ± SD, mon)	10.37 ± 8.87	10.92 ± 10.54	1.000^†	10.56 ± 9.26

V/A = visual acuity; IOP = intraocular pressure.

^* Statistically significance;

^† p-value by Mann-Whitney analysis;

^‡ p-value by Fischer’s exact analysis.

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