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Retinal tuft (vitroretinal tuft) is a disorder or degeneration of the retina in the eye. [1] Retinal tufts are classified as a peripheral retinal degenerations and can be categorized as either cystic or zonular tractional. [2] Retinal tufts can be visualized or diagnosed using a dilated eye examination and indirect ophthalmoscope or a widefield retinal scan. [3] A retinal tuft is a gliotic degeneration of the retina composed of focal adhesions in the extracellular matrix joining the retina and the posterior hyaloid of the eye. [4] [5]
Retinal tufts are a common lesion of the retina and under 1% of these tufts are thought to lead to retinal detachment. [2] [6] The risk of a retinal detachment from a retinal tuft has been estimated to be about 0.28% and there is usually no treatment necessary for this condition. [7]
Cystic retinal tufts affect 5% of the population and are thought to be a congenital abnormality in the retina. [7] Cystic tufts are more commonly found under the vitreous base in the peripheral of the retina, but can also be found in other parts of the retina. [1] In this condition, the retina can be stretched by the vitreous humor. Long term vitreous traction (stretching) of the retina is thought to be what is associated with the increased risk of tears to the retina or retinal detachment. [1] Under a microscope looking at the histology of a cystic retinal tuft, an increase in glial cells, breaking down of the outer retina, and a loss in photoreceptor cells is often detected. [8]
Retinal tufts can classified into three subtypes: cystic, non-cystic, and zonular traction retinal tufts. [5] Cystic tufts are usually larger than 0.1mm in length. [5] Non-cystic retinal tufts are usually shorter, less than 0.1mm in length and are often clustered together in a series of projections within the vitreous base. [5] Zonular traction retinal tufts are usually made up of thing individual strands that are usually in the vitreous base and extend over the area where the rod and cone of the eye end (ora serrata). [5]
Retinal tufts are related to pulling or traction of the vitreous humor. They are characterized by areas of gliotic degeneration on parts of the retina. [1]
Most retinal tufts are stable and do not change over time. Due to the traction that is placed on the vitreous humor, the retinal tuft may change in shape. Retinal tufts increase the risk of a retinal tear or a detached retina, although the risk is not high- 1% of tufts are thought to lead to retinal detachment. [2] [6] In addition if there is retinal thinning near a zonular traction tuft, there is an increased risk of retinal detachment. [5]
Cystic tufts lead are often associated with an increased risk of rhegmatogenous retinal detachments. [5]
The vitreous body is the clear gel that fills the space between the lens and the retina of the eyeball in humans and other vertebrates. It is often referred to as the vitreous humor, from Latin meaning liquid, or simply "the vitreous". Vitreous fluid or "liquid vitreous" is the liquid component of the vitreous gel, found after a vitreous detachment. It is not to be confused with the aqueous humor, the other fluid in the eye that is found between the cornea and lens.
Retinoschisis is an eye disease characterized by the abnormal splitting of the retina's neurosensory layers, usually in the outer plexiform layer. Retinoschisis can be divided into degenerative forms which are very common and almost exclusively involve the peripheral retina and hereditary forms which are rare and involve the central retina and sometimes the peripheral retina. The degenerative forms are asymptomatic and involve the peripheral retina only and do not affect the visual acuity. Some rarer forms result in a loss of vision in the corresponding visual field.
Retinopathy of prematurity (ROP), also called retrolental fibroplasia (RLF) and Terry syndrome, is a disease of the eye affecting prematurely born babies generally having received neonatal intensive care, in which oxygen therapy is used because of the premature development of their lungs. It is thought to be caused by disorganized growth of retinal blood vessels and may result in scarring and retinal detachment. ROP can be mild and may resolve spontaneously, but it may lead to blindness in serious cases. Thus, all preterm babies are at risk for ROP, and very low birth-weight is an additional risk factor. Both oxygen toxicity and relative hypoxia can contribute to the development of ROP.
This is a partial list of human eye diseases and disorders.
Retinal detachment is a disorder of the eye in which the retina peels away from its underlying layer of support tissue. Initial detachment may be in a very small region, but without rapid treatment the entire retina may detach, leading to vision loss and blindness. It is a surgical emergency.
Retinal hemorrhage is a disorder of the eye in which bleeding occurs in the retina, the light sensitive tissue, located on the back wall of the eye. There are photoreceptor cells in the retina called rods and cones, which transduce light energy into nerve signals that can be processed by the brain to form visual images. Retinal hemorrhage is strongly associated with child abuse in infants and young children and often leaves such abused infants permanently blind. In older children and adults, retinal hemorrhage can be caused by several medical conditions such as hypertension, retinal vein occlusion, anemia, leukemia or diabetes.
A posterior vitreous detachment (PVD) is a condition of the eye in which the vitreous membrane separates from the retina. It refers to the separation of the posterior hyaloid membrane from the retina anywhere posterior to the vitreous base.
Metamorphopsia is a type of distorted vision in which a grid of straight lines appears wavy or partially blank. In addition, metamorphopsia can result in misperceptions of an object's size, shape, or distance to the viewer. People can first notice they suffer from the condition when looking at mini blinds in their home.
Eales disease is a type of obliterative vasculopathy, also known as angiopathia retinae juvenilis, periphlebitis retinae or primary perivasculitis of the retina. It was first described by the British ophthalmologist Henry Eales (1852–1913) in 1880 and is a rare ocular disease characterized by inflammation and possible blockage of retinal blood vessels, abnormal growth of new blood vessels (neovascularization), and recurrent retinal and vitreal hemorrhages.
Intravitreal administration is a route of administration of a drug, or other substance, in which the substance is delivered into the vitreous humor of the eye. "Intravitreal" literally means "inside an eye". Intravitreal injections were first introduced in 1911 when Ohm gave an injection of air into the vitreous humor to repair a detached retina. In the mid-1940s, intravitreal injections became a standard way to administer drugs to treat endophthalmitis and cytomegalovirus retinitis.
Lattice degeneration is a disease of the human eye wherein the peripheral retina becomes atrophic in a lattice pattern. Usually, this happens slowly over time and does not cause any symptoms, and medical intervention is neither needed nor recommended.
Optic pit, optic nerve pit, or optic disc pit (ODP) is rare a congenital excavation (or regional depression) of the optic disc (also optic nerve head), resulting from a malformation during development of the eye. The incidence of ODP is 1 in 10,000 people with no predilection for either gender. There is currently no known risk factors for their development. Optic pits are important because they are associated with posterior vitreous detachments (PVD) and even serous retinal detachments.
A macular hole is a small break in the macula, located in the center of the eye's light-sensitive tissue called the retina.
Acute retinal necrosis (ARN) is a medical inflammatory condition of the eye. The condition presents itself as a necrotizing retinitis. The inflammation onset is due to certain herpes viruses, varicella zoster virus (VZV), herpes simplex virus (HSV-1 and HSV-2) and Epstein–Barr virus (EBV).
Intraocular hemorrhage is bleeding inside the eye. Bleeding can occur from any structure of the eye where there is vasculature or blood flow, including the anterior chamber, vitreous cavity, retina, choroid, suprachoroidal space, or optic disc.
Proliferative vitreoretinopathy (PVR) is a disease that develops as a complication of rhegmatogenous retinal detachment. PVR occurs in about 8–10% of patients undergoing primary retinal detachment surgery and prevents the successful surgical repair of rhegmatogenous retinal detachment. PVR can be treated with surgery to reattach the detached retina but the visual outcome of the surgery is very poor. A number of studies have explored various possible adjunctive agents for the prevention and treatment of PVR, such as methotrexate, although none have yet been licensed for clinical use.
Vitreomacular adhesion (VMA) is a human medical condition where the vitreous gel of the human eye adheres to the retina in an abnormally strong manner. As the eye ages, it is common for the vitreous to separate from the retina. But if this separation is not complete, i.e. there is still an adhesion, this can create pulling forces on the retina that may result in subsequent loss or distortion of vision. The adhesion in of itself is not dangerous, but the resulting pathological vitreomacular traction (VMT) can cause severe ocular damage.
Atul Kumar is an Indian ophthalmologist who is currently the Chief & Professor of Ophthalmology at Dr. Rajendra Prasad Centre for Ophthalmic Sciences (RPC-AIIMS), the national apex ophthalmic centre at All India Institute of Medical Sciences, Delhi. He was awarded the Padma Shri award in January 2007 for his services to the medical field. He specializes in vitreoretinal surgery and also heads the Vitreo-Retinal, Uvea and ROP services at RPC-AIIMS.
Sickle cell retinopathy can be defined as retinal changes due to blood vessel damage in the eye of a person with a background of sickle cell disease. It can likely progress to loss of vision in late stages due to vitreous hemorrhage or retinal detachment. Sickle cell disease is a structural red blood cell disorder leading to consequences in multiple systems. It is characterized by chronic red blood cell destruction, vascular injury, and tissue ischemia causing damage to the brain, eyes, heart, lungs, kidneys, spleen, and musculoskeletal system.
Vitreomacular traction syndrome (VTS) is a medical condition in the eye that is the result of tractional forces (pulling) being placed on the retina. VTS is common in people who have an incomplete posterior vitreous detachment, a type of retinal detachment at the periphery of the retina. In these cases the retina is still attached to the retina in some places and this results in a pulling or 'tractional' force that causes VTS that includes lesions on retina.
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