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Phakic retinal detachments in the elderly
1Department of Ophthalmology, Greater Baltimore Medical Center, Baltimore, Maryland 21204, USA.
Purpose:
To discover if clinical nontraumatic phakic retinal detachments in the elderly possess characteristics that distinguish them from similar cases in younger persons.
Methods:
A retrospective study of 100 consecutive cases in patients aged 70 years and older was performed. Recorded data included patient age and sex, type and location of retinal break, extent of detachment, and associated vitreoretinal pathology.
Results:
Approximately 90% of retinal breaks were horseshoe tears, and the majority were located in the superior temporal quadrant. Horseshoe tears confined to the posterior margin of the vitreous base were responsible for retinal detachments in 30% of cases, and an additional 36% of breaks were located anterior to the equator.
Conclusion:
The incidence of this type of anterior break is higher than that previously described for phakic retinal detachments, although previous studies have not discussed break types as a function of old age. Anterior horseshoe tears, which cause many phakic retinal detachments in the elderly, may not be caused by acute posterior vitreous detachment, but rather to persistent chronic traction on the vitreous base after posterior vitreous detachment.