Avulsed retinal vessels with and without retinal breaks--treatment and extended follow-up.

Between 1975 and 1984 65 cases of avulsed retinal vessels were studied. Of these 57 had avulsed vessels with retinal tear and 8 without. Of the affected eyes: 55.38 per cent were emmetropic, while myopia was present only in 29.23 per cent. Degenerative alterations (lattice-like lesions) were found in 4.61 per cent of cases. Argon laser treatment was applied in 30 cases (Group A), episcleral sponge implant with cryopexy and, in some instances, subsequent laser treatment in 34 cases (Group B). In one case vitrectomy with endodiathermy was performed. With the silastic sponge implants (Group B) we tried to obtain a high buckle in order to achieve immobilisation of the avulsed vessel through contact with the implant. The implants were applied in cases of avulsed vessels located posterior to the equator. Group B (sponge implant) showed fewer haemorrhagic recurrences after treatment than did Group A (laser application), the difference however was not statistically significant. It is also worth mentioning that in Group B the avulsed vessels which were occluded or empty of blood were to a statistically significant extent more numerous than in the laser-treated Group A. Retinal breaks with one or more avulsed retinal vessels constitute a distinct but uncommon clinical entity, which was first noted by Clark in 1962. Retinal vessels can also be avulsed by vitreous traction without a concurrent retinal tear, but can also be avulsed by vitreous traction without a concurrent retinal tear, but this condition is found much more rarely.(ABSTRACT TRUNCATED AT 250 WORDS)