Dear Dr John Hagan,
Thank you so much for your answer!
Regards
Jolimadam
Dr. O no longer answers questions on the forum. First not every case of lattice and floaters needs laser. I have lattice and floaters and have never had laser. But what is done is done. Your observation has been described numerous times before in these forums following laser, freezing (cryotherapy), retina surgery such as scleral buckle for retinal detachment and macular surgery. The laser creates a thermal burn and subsequent scar formation that hopefully will seal holes or thin areas. However it also stimulates the retina and can generate bright spots (positive images) and darks spots (negative images) usually 180 degrees away from the treated area. Usually these get better over weeks to months. You can use the search feature to read more extended discussions.
Retinal tears or holes.
Dr. O.
Dr. O
Just want to clarify. Do you mean
"8 to 10 % of the population have retinal thin ...." or retinal tears.
Basically, you agree with what I heard that no solid evidence showing that a laser treatment can effectively stop tears. It may be more worthwhile to do the treatment when there is actually a tear happen. Do you agree ?
Thanks
Taurus
8 to 10 % of the population have retinal tears on autopsy studies.
There are only a few prospective studies. The best one from the 70's found that 35% of acute retinal tears (horseshoe tears--NOT hole) lead to detachment. That means 65% do not lead to detachment. The complications of treatment are macular pucker (epiretinal membrane) and retinal detachment (together 5%). Retinal tears without symptoms (flashes and floater-or a sudden change in floaters) rarely lead to retinal detachment.
Most patients with thin areas of the retina have lattice degeneration. Unfortunately, retinal tears occur in areas outside of lattice. Therefore to prevent a tear, the entire peripheral retina has to be lasered. This increases the chance of complications such as macular pucker. I have removed cataracts in patients with multiple old horseshoe tears without have a retinal detachment. One engineer who had a acute retinal tear about 5 years ago decided to have it followed against my advice and he did not develop a retinal detachment. 4 years later I removed his cataract without a problem.
Unfortunately, there is a benefit to the doctor for treatment and a questionable benefit to the patient.
Dr. O.
Correction of the original comment
Dr Oyakawa:
Would you mind give me some advice on why don't you recommend ? Is it because of the side effect ? Or the chance of a thin retinal develop to retinal tears and then retinal detachment is small ?
I also heard that there is no solid statistic to support that the laser treatment can effectively stop the a retinal thin to develop to tears. Is it true ?
Thanks
Wilson
Dr Oyakawa:
Would you mind give me some advice on why don't you recommend ? Is it because of the side effect ? Or the chance of a thin retinal develop to retinal tears and then retinal detachment is small ?
I also heard that there is solid statistic to support that the laser can effectively stop the a retinal thin to tears. Is it true ?
Thanks
Wilson
I would not recommend laser treatment for area of retinal thinning. Get a second opinion from a retinal specialist.
Dr. O.