When examining the peripheral retina of otherwise normal subjects, it is surprising to find that from time to time there are quite striking degenerative changes. Perhaps this is not so surprising when one considers that the retinal arteries are end arteries and these changes occur in the peripheral parts of the retina supplied by the distal part of the circulation. Peripheral retinal degenerations are more commonly seen in myopic eyes, especially in association with Marfan's and Ehlers-Danlos syndromes and Stickler's disease (see reading list).
Different types of degeneration have been described and named and certain types are recognised as being the precursors to formation of retinal breaks. The most important degenerations are lattice degeneration and retinal tufts. Lattice degenerations consist of localised areas of thinning in the peripheral retina. Progressive thinning of the retina within areas of lattice degeneration can eventually lead to formation of retinal "holes".
In addition, both lattice degenerations and retinal tufts also represent areas with abnormally strong adhesions between the vitreous and the retina. The presence of exaggerated vitreoretinal adhesions can result in the formation of retinal "tears" within areas of lattice degeneration and retinal tufts during posterior vitreous detachment (see below).
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