Giant Retina Tear in an African Population: Presentation and Fellow Eyes

Aim: To examine the profile and presentation of a consecutive series of giant retinal tears (GRTs) in an African population. Also to review the clinical state of the patient’s fellow eyes. Method: A retrospective observational case series of thirty-six consecutive eyes of 36 patients with a GRT retina detachment that had vitreoretina surgery done between April 2006 and June 2013. All information was extracted from the patient’s case records. Result: Thirty-nine case records had surgery consecutively within the study period. Three case records had incomplete data and were excluded from the analysis. Thirty-six eyes were analyzed. There were mostly males (80.6%), age range 21 - 65 yrs (mean age 47 yrs). The commonest etiology was idiopathic (21 eyes). Presenting visual acuity was mostly in the counting finger and hand motion range (83%), and the mean presenting intraocular pressure was 6.8 mmHg. Most of the eyes presented with a total retina detachment (4 quadrant involvement; 56%), macular involvement (96%), commonest size of the retina tear being between 90 to 180 degrees in 20 eyes; rolled over retina flap (61%) and advanced grades of PVR being very common (83%). The commonest fellow eye event noted was blindness in 16 fellow eyes; while 12 eyes had prophylactic retina laser photocoagulation to peripheral predisposing retina lesions. Conclusion: The presentation of GRT in a low resource country is often as a complex retina detachment situation, which may arise from frequent delays to assess care and other socioeconomic issues. This carries significant implications on prognosis following surgical intervention. Also this study raises the awareness that fellow eyes of GRT in Africa are at increased risk of blindness and require more careful attention.