Abstract
Aim: To examine the profile and presentation of a consecutive series of giant retinal tears (GRTs) in an African population. Also to review the clinical state of the patient’s fellow eyes. Method: A retrospective observational case series of thirty-six consecutive eyes of 36 patients with a GRT retina detachment that had vitreoretina surgery done between April 2006 and June 2013. All information was extracted from the patient’s case records. Result: Thirty-nine case records had surgery consecutively within the study period. Three case records had incomplete data and were excluded from the analysis. Thirty-six eyes were analyzed. There were mostly males (80.6%), age range 21 - 65 yrs (mean age 47 yrs). The commonest etiology was idiopathic (21 eyes). Presenting visual acuity was mostly in the counting finger and hand motion range (83%), and the mean presenting intraocular pressure was 6.8 mmHg. Most of the eyes presented with a total retina detachment (4 quadrant involvement; 56%), macular involvement (96%), commonest size of the retina tear being between 90 to 180 degrees in 20 eyes; rolled over retina flap (61%) and advanced grades of PVR being very common (83%). The commonest fellow eye event noted was blindness in 16 fellow eyes; while 12 eyes had prophylactic retina laser photocoagulation to peripheral predisposing retina lesions. Conclusion: The presentation of GRT in a low resource country is often as a complex retina detachment situation, which may arise from frequent delays to assess care and other socioeconomic issues. This carries significant implications on prognosis following surgical intervention. Also this study raises the awareness that fellow eyes of GRT in Africa are at increased risk of blindness and require more careful attention.
Highlights
Giant retina tear represents one of the more complex forms of retina tears and detachment
Though cases of giant retina tear and detachment have been reported in several publications from western, wealthier nations, not much is know about the presentation of giant retina tear and detachment cases, the fellow eye and the surgical repair in an African context [1] [2] [3] [4]
The delay in presentation by the patients and scarce resources could prove to be a challenge in giant retina tear cases which are known to have a higher incidence of proliferative vitreoretinopathy (PVR) and are prone to recurrent retina detachment
Summary
Giant retina tear represents one of the more complex forms of retina tears and detachment. It is defined as a tear involving three or more clock hours or greater than 90 degrees in the presence of a posterior vitreous detachment (PVD). Though cases of giant retina tear and detachment have been reported in several publications from western, wealthier nations, not much is know about the presentation of giant retina tear and detachment cases, the fellow eye and the surgical repair in an African context [1] [2] [3] [4]. The first part examines the presentation of giant retina tear detachment eyes and reviews their fellow eyes. A review of the presentation of these eyes and the fellow eye in an African population will provide a better understanding of the presentation of this condition in the region and help contrast the situation from that in other regions
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