Early diagnosis and treatment of the retinal breaks

Objective To investigate the most practical examination method for diagnosis and treatment of retinal breaks and evaluate the value of early diagnosis and treatment for retinal breaks. Methods A total of 192 patients (216 eyes) diagnosed as posterior vitreous detachment (PVD) by ophthalmic A/B ultrasound underwent indirect ophthalmoscope, 90D mirror under the slit lamp, and three-mirror lens fundus examinations after mydriasis. Patients with retinal breaks uncombined with peripheral retinal detachment or accompanied by local superficial detachment were treated by 532 nm laser photocoagulation around the breaks; while patients with retinal breaks accompanied by peripheral retinal detachment were treated by surgery. Results In 216 eyes of PVD patients, 28 eyes of retinal tears were found by indirect ophthalmoscope, accounting for 12.96%; 26 eyes of retinal tears were found by the 90D under the slit lamp, accounting for 12.04%; 31 eyes of retinal tears were found by three-mirror lens, accounting for 14.35%, and there was no significant difference among the three groups inexamination results (P>0.05). Twenty-two eyes with retinal tears uncombined with peripheral retinal detachment underwent preventive photocoagulation treatmen for once; 6 eyes with retinal tears accompanied by local superficial detachment underwent retinal photocoagulation for 2 times; 3 eyes with retinal breaks accompanied by large range retinal detachment underwent scleral cryotherapy combined with scleral buckling. Followed up for 6 months, all the patients with retinal breaks had good therapeutic effect, without new retinal detachment. Conclusions Early detection and early diagnosis for retinal breaks are very important. The timely and proper treatment of retinal photocoagulation is the key to prevent the occurrence of retinal detachment; three-mirror lens is still very useful to detect retinal breaks. Primary level doctors should pay attention to the the importance and application of these methods. Key words: Retinal breaks; Posterior vitreous detachment; Photocoagulation; Early diagnosis; Treatment