title: Giant retinal tears.
abstract: A giant retinal tear (GRT) is a full-thickness neurosensory retinal break that extends circumferentially around the retina for three or more clock hours in the presence of a posteriorly detached vitreous. Its incidence in large population-based studies has been estimated as 1.5% of rhegmatogenous retinal detachments, with a significant male preponderance, and bilaterality in 12.8%. Most GRTs are idiopathic, with trauma, hereditary vitreoretinopathies and high myopia each being causative in decreasing frequency. The vast majority of GRTs are currently managed with a pars plana vitrectomy; the use of adjunctive circumferential scleral buckling is debated, but no studies have shown a clear anatomical or visual advantage with its use. Similarly, silicone oil tamponade does not influence long-term outcomes when compared with gas. Primary and final retinal reattachment rates are achieved in 88% and 95% of patients, respectively. Even when the retina remains attached, however, visual recovery may be limited. Furthermore, fellow eyes of patients with a GRT are at higher risk of developing retinal tears and retinal detachment. Prophylactic treatment under these circumstances may be considered but there is no firm evidence of its efficacy at the present time.
authors.affiliation: The Tun Hussein Onn National Eye Hospital, Selangor, Malaysia. Electronic address: mano.shun@gmail.com.
authors.forename: Manoharan
authors.initials: M
authors.lastname: Shunmugam
authors.affiliation: The Royal Victorian Eye & Ear Hospital, Melbourne, Australia.
authors.forename: Ghee Soon
authors.initials: GS
authors.lastname: Ang
authors.affiliation: Centre for Vision and Vascular Science, Queen's University, Belfast, Northern Ireland, UK.
authors.forename: Noemi
authors.initials: N
authors.lastname: Lois
mesh_terms: D002387:Cataract Extraction / Q000009:adverse effects; D003937:Diagnosis, Differential; D005131:Eye Injuries / Q000150:complications; D006801:Humans; D018918:Phacoemulsification / Q000379:methods; D012167:Retinal Perforations / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D012307:Risk Factors; D014821:Vitrectomy / Q000379:methods