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Abstract
Purpose
To investigate the relationship between peripheral retinal degeneration including retinal tear and character of floater and flash in patients with symptoms.
Methods
A retrospective review of 56 patients who visited Dong-A University Hospital with the symptoms of vitreous floaters and flash between July 2017 and March 2018 was performed using medical records. All patients completed a questionnaire detailing their symptoms include duration of symptoms, characters, floaters with flash and associated another visual symptom (e.g., headache, whiteout) had been performed full ophthalmic examination.
Results
A total of 56 eyes were included in this study, including 22 eyes (39.3%) of retinal breaks and peripheral retinal degeneration and 34 eyes (60.7%) of no peripheral retinal degeneration. Univariated analysis showed that the onset of symptoms within 1 week, multiple floaters particularly for the number from 2 to 5, and existence of posterior vitreous detachment are meaningful factor. Laser photocoagulation was performed in patients with peripheral retinal degeneration including retinal tears requiring treatment. No additional breaks were observed in all patients during the 6-month follow-up.
Conclusions
Patients with floaters and flash should be thoroughly asked with regard to the onset and number of floaters, and if the onset of symptom is within one week or patients feel multiple floaters, thorough peripheral fundus examination to find peripheral retinal degeneration including retinal tears should be needed.
Figures and Tables
Figure 1
The characters of floaters. Questionnaire detailing their symptoms include onset, duration of symptoms, floaters with flash and associated another visual symptoms (e.g., headache, whiteout) and past medical histories had been performed. The characters of floaters were categorized by the pictures classified into four groups from the previous independent study of van Overdam et al6 (with permission of JAMA Ophthalmology).
Table 1
Comparison of demographics, previous eye status and past medical history between patients with retinal breaks and control
Values are presented as mean ± standard deviation or number (%) unless otherwise indicated.
OD = oculus dexter; OS = oculus sinister; OU = oculus unitas; D = diopters; DM = diabetes mellitus.
*Statistical significance was determined using the Fisher exact test, chi-square test from cross-table analysis; †odd ratio, 4.48; ‡statistical significance was determined using the t-test.
Table 2
Comparison of characteristics of vitreous floater symptoms
Values are presented as number (%) unless otherwise indicated.
*Statistically significance is p < 0.05 chi-square test from cross-table analysis; †group A indicates 1 to 3 floaters; group B, 4 to 10 floaters; group C, more than 10 floaters; and group D, a curtain or cloud; ‡odd ratio, 26.6; §statistically significance is p < 0.05 chi-square test and Fisher's exact test from cross-table analysis.
Notes
References
1. Milston R, Madigan MC, Sebag J. Vitreous floaters: etiology, diagnostics, and management. Surv Ophthalmol. 2016; 61:211–227.
2. Murakami K, Jalkh AE, Avila MP, et al. Vitreous floaters. Ophthalmology. 1983; 90:1271–1276.
3. Hollands H, Johnson D, Brox AC, et al. Acute-onset floaters and flashes: is this patient at risk for retinal detachment. JAMA. 2009; 302:2243–2249.
4. Byer NE. Natural history of posterior vitreous detachment with early management as the premier line of defense against retinal detachment. Ophthalmology. 1994; 101:1503–1514.
5. Boldrey EE. Risk of retinal tears in patients with vitreous floaters. Am J Ophthalmol. 1983; 96:783–787.
6. van Overdam KA, Bettink-Remeijer MW, Klaver CC, et al. Symptoms and findings predictive for the development of new retinal breaks. Arch Ophthalmol. 2005; 123:479–484.
7. Uchino E, Uemura A, Ohba N. Initial stages of posterior vitreous detachment in healthy eyes of older persons evaluated by optical coherence tomography. Arch Ophthalmol. 2001; 119:1475–1479.
8. Diamond JP. When are simple flashes and floaters ocular emergencies? Eye (Lond). 1992; 6 ( Pt 1):102–104.
9. Jeong SH, Lee DW, Cho HJ, et al. Risk factors for retinal breaks in patients with symptom of floaters. J Korean Ophthalmol Soc. 2014; 55:1162–1166.
10. Dayan MR, Jayamanne DG, Andrews RM, Griffiths PG. Flashes and floaters as predictors of vitreoretinal pathology: is follow-up necessary for posterior vitreous detachment? Eye (Lond). 1996; 10 ( Pt 4):456–458.
11. Sharma MC, Regillo CD, Shuler MF, et al. Determination of the incidence and clinical characteristics of subsequent retinal tears following treatment of the acute posterior vitreous detachment-related initial retinal tears. Am J Ophthalmol. 2004; 138:280–284.
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