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2014 ; 2014
(9
): CD003170
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Interventions for asymptomatic retinal breaks and lattice degeneration for
preventing retinal detachment
#MMPMID25191970
Wilkinson CP
Cochrane Database Syst Rev
2014[Sep]; 2014
(9
): CD003170
PMID25191970
show ga
BACKGROUND: Asymptomatic retinal breaks and lattice degeneration are visible
lesions that are risk factors for later retinal detachment. Retinal detachments
occur when fluid in the vitreous cavity passes through tears or holes in the
retina and separates the retina from the underlying retinal pigment epithelium.
Creation of an adhesion surrounding retinal breaks and lattice degeneration, with
laser photocoagulation or cryotherapy, has been recommended as an effective means
of preventing retinal detachment. This therapy is of value in the management of
retinal tears associated with the symptoms of flashes and floaters and persistent
vitreous traction upon the retina in the region of the retinal break, because
such symptomatic retinal tears are associated with a high rate of progression to
retinal detachment. Retinal tears and holes unassociated with acute symptoms and
lattice degeneration are significantly less likely to be the sites of retinal
breaks that are responsible for later retinal detachment. Nevertheless, treatment
of these lesions frequently is recommended, in spite of the fact that the
effectiveness of this therapy is unproven. OBJECTIVES: The objective of this
review was to assess the effectiveness and safety of techniques used to treat
asymptomatic retinal breaks and lattice degeneration for the prevention of
retinal detachment. SEARCH METHODS: We searched CENTRAL (which contains the
Cochrane Eyes and Vision Group Trials Register) (2014, Issue 2), Ovid MEDLINE,
Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid
OLDMEDLINE (January 1946 to February 2014), EMBASE (January 1980 to February
2014), PubMed (January 1948 to February 2014), the metaRegister of Controlled
Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov
(www.clinicaltrials.gov) and the World Health Organization (WHO) International
Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did
not use any date or language restrictions in the electronic searches for trials.
We last searched the electronic databases on 19 February 2014. Textbooks
regarding retinal detachment and the reference lists of relevant reports were
reviewed for additional study reports. We contacted experts in the field for
details of other published and unpublished studies. SELECTION CRITERIA: This
review was designed to include randomized controlled trials in which one
treatment for asymptomatic retinal breaks and lattice degeneration was compared
with another treatment or no treatment. DATA COLLECTION AND ANALYSIS: Initially,
one author assessed the search results and collected relevant studies. Since no
studies met the inclusion criteria, no studies were assessed for risk of bias. No
data were extracted and no meta-analysis could be performed. MAIN RESULTS: No
trials were found that met the inclusion criteria for this review. AUTHORS'
CONCLUSIONS: No conclusions could be reached about the effectiveness of surgical
interventions to prevent retinal detachment in eyes with asymptomatic retinal
breaks or lattice degeneration, or both. Current recommendations for treatment,
based upon a consensus of expert opinion, should be assessed in a randomized
controlled trial.