Atrophic Hole
𝘋𝘦𝘴𝘤𝘳𝘪𝘱𝘵𝘪𝘰𝘯:
● Full thickness break in the retina not associated with vitreoretinal traction
● Round or oval in shape
● Isolated/ Within areas of lattice degeneration/ adjacent to them
● They maybe surrounded by pigmentation - especially if they are chronic or within a patch of lattice degeneration
● Subretinal fluid can form a cuff around it - can cause a symptomatic or asymptomatic retinal detachment
● Scleral depression maybe needed to pick up the pathology
● Low risk of retinal detachment
𝘗𝘢𝘵𝘩𝘰𝘨𝘦𝘯𝘦𝘴𝘪𝘴:
● Chronic atrophy and thinning of the neurosensory retina
● Secondary to poor vascular supply due to poorly functioning choriocapillaries that no longer give adequate blood to the retinal layers above the hole causing retinal vessel sclerosis and disturbance of overlying vitreous
● Associated with ageing
𝘚𝘺𝘮𝘱𝘵𝘰𝘮𝘴:
● Usually asymptomatic
● Some patients have floaters, photopsias or loss of visual field
𝘛𝘳𝘦𝘢𝘵𝘮𝘦𝘯𝘵:
Usually do not require treatment and can be observed.
Prophylactic barrage laser can be done in:
● Patients with symptoms
● When there is SRF
● History of retinal detachment in the fellow eye
www.ophthalmobytes.com
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