New ares of lattice degeneration in high myope

[Arnoldschwarz]

So on my routine eye checkup I was diagnosed with new areas of lattice degeneration (superior in my left eye and inferior in my right) that should be lasered in my Doctor’s opinion. The thing is I have no new symptoms and these areas don’t have accompanying holes or tears. I’m getting a second opinion on my original retinal surgeon that has examined me before but I couldn’t contact earlier regarding laser retinopexy. My question is what would be the possible cause of the new areas of lattice formation. I’m a healthy 24 y/o man with only condition being high myopia (Right eye -7.5; Left about -9.5). I’m following my doctors reccomendations and have a good diet, don’t lift anything heavier than 20lbs most of the time if I don’t have to and only sports are swimming, bike rides and walking. I’m not doing physically exhausting job. The only thing I did was a pretty long and exhausting bike ride last week where I was speeding and was out of breath at the end (but No head injuries)? Could physical exertion be the cause of new lattice areas forming in my eyes?

[John C Hagan III, MD, FACS, FAAO]

New areas of lattice do develop but not in response to physical effort.  There is great disagreement among ophthalmologist, even specially trained retina surgeons, about which areas of lattice to treat. You are wise to consult your retina surgeon. Generally if not holes, tears or traction not treated  especially inferior. Superior lattice, because of gravity, is at higher risk of causing RD than inferior.  Superior outside (ear side) is more concerning because over the macula.

[Arnoldschwarz]

Hello Doctor, so I went for a routine checkup to my Retinal specialist and the good news is I don’t have any sinister findings that need laser retinopexy treatment and the areas with lattice degeneration were ranked as „small”  in both eyes by my eye MD and to continue observation. The only thing that worries me is persistent small amount of subretinal fluid that accompanies the atrophic hole at 11 o’clock in my left eye - it was treated with laser retinopexy about 8 months ago and my Doctor said that the fluid doesn’t pass the laser demarcation line and the treated area is stable. My doctor’s answer about the fluid was quite vague and he said that the fluid may never reabsorb. So my question is:

1. Is there a chance that the subretinal fluid will ever reabsorb since it is still present around the atrophic hole which was succesfully treated after 8 months?
2. Does the fact that subretinal fluid is still present put me at a significant higher risk of detachment of treated area and progression to clinical retinal detachment in comparison to treated area without siubretinal fluid?
3. Does the subretinal fluid itself put pressure on the lasered area which might cause RD?

[John C Hagan III, MD, FACS, FAAO]

General: what your doctor told you is the case usually.
1. It might reabsorb but that is not the definition of successful treatment. Success is creating scars/adhesions from laser that prevent fluid from getting under the retina and detaching it.
2. no, not if the surgeon is satisfied with the the results of the laser treatment.
3. No   The pressure surgeons worry about is from the formed vitreous gel pulling on the retina.

[Arnoldschwarz]

Thank you Doctor for your answer and educating on this issue.

[John C Hagan III, MD, FACS, FAAO]

You are welcome, best of luck. Changes of good result are high.