Retinal gaps

Retinal gaps are profound defects in the sensory retina. Discontinuities of the retina are distinguished by pathogenesis, morphology, and localization.

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Pathogenesis of retinal ruptures

Rupture of the retina is a consequence of vitreoretinal tracts and occur in the upper half of the retina (most often with the temporal, more rarely - from the nose). Holes in the retina occur as a result of chronic retinal atrophy and are round or oval. They are mainly located on the temporal side (most often at the top, rarely at the bottom); in comparison with retinal gaps, they are less dangerous.

Morphology of retinal ruptures

Retinal gaps have several configurations.

• U-shaped retinal ruptures (arrow-shaped tears). These ruptures have a valve with a tip that is tightened by a vitreous body, and a base attached to the retina itself. Such gaps consist of two parallel running strips that are joined at the apex directed towards the posterior segment of the eyeball. Incomplete U-shaped discontinuities can be linear or L-shaped.
• Gaps of the retina with a "lid", in which the valve is completely torn off "the consequence of detachment of the vitreous.
• The detachments are referred to peripheral ruptures along the "dentate" line with the attachment of the vitreous to the posterior edge of the retina rupture.
• Giant retinal ruptures span from 90 or more of the periphery of the retina. They are represented by various forms of U-shaped ruptures with the attachment of the vitreous to the anterior edge of the rupture. Gigantic ruptures are locally located behind the "dentate" line and, less often, the equator area.

Localization of retinal ruptures

• "Toothed" line - rupture of the retina at the base of the vitreous body.
• Behind the "dentate" line is the rupture of the retina between the posterior border of the base of the vitreous and the equator.
• Equatorial - retinal rupture at the equator.
• Behind the equator is the retinal rupture behind the equator.
• Macula - rupture of the retina in the form of a hole in the macular area.

Ruptures and detachments of the retina are red and have a different shape. Distinctions are perforated, valve, with a cap, atypical. Gaps can be single and multiple, central and paracentral, equatorial and paraoral (located near the dentate line). The type, localization and size of the gap largely determine the topography and the rate of spread of the retinal detachment. When the ruptures are located in the upper half of the fundus, the detachment, as a rule, progresses much more rapidly than with lower ruptures and detachments. Most often, the gaps are localized in the upper-arm quadrant of the fundus. The doctor, having discovered one gap in the retina, must necessarily continue the search, sequentially examining the central and paracentral, and then the equatorial and paraoral sections of the fundus by the meridians, since the detection and blockade of all the retinal ruptures determines both the choice of the optimal intervention method and its effectiveness. It is also necessary to identify vitreoretinal fusion.

Treatment of retinal rupture

When performing the operation at a modern technical level, it is possible to achieve a retina fit in 92-97% of patients. In the early postoperative period, local and general anti-inflammatory therapy with non-steroidal and steroid drugs, systemic enzyme therapy in the presence of hemorrhages is indicated. In the future, it is advisable to conduct repeated courses of treatment, including drugs that normalize hemodynamics and microcirculation of the eye. Patients operated on for retinal detachment should be under the supervision of an ophthalmologist and avoid physical overload