Highlighted Findings and Recommendations for Care

Document Overview

Design and created by Guideline Central in participation with the American Academy of Ophthalmology.

Posterior Vitreous Detachment, Retinal Breaks, and Lattice Degeneration

American Academy of Ophthalmology

Publication Date: Feb 7, 2025

Page Last Updated: May 5, 2026

Recommendation Grading

Study Ratings¹
I++	High-quality meta-analyses, systematic reviews of randomized controlled trials (RCTs), or RCTs with a very low risk of bias
I+	Well-conducted meta-analyses, systematic reviews of RCTs, or RCTs with a low risk of bias
I-	Meta-analyses, systematic reviews of RCTs, or RCTs with a high risk of bias
II++	High-quality systematic reviews of case-control or cohort studies High-quality case-control or cohort studies with a very low risk of confounding or bias and a high probability that the relationship is casual
II+	Well-conducted case-control or cohort studies with a low risk of confounding or bias and a moderate probability that the relationship is casual
II-	Case-control or cohort studies with a high risk of confounding or bias and a significant risk that the relationship is not casual
III	Nonanalytic studies (e.g., case reports, case series
Evidence Ratings²
G - Good quality	Further research is very unlikely to change our confidence in the estimate of effect
M - Moderate quality	Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate
In - Insufficient quality	Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate Any estimate of effect is very uncertain
Recommendation Ratings³
S - Strong recommendation	Used when the desirable effects on an intervention clearly outweigh the undesirable effects or clearly do not
D - Discretionary recommendation	Used when the trade-offs are less certain—either because of low-quality evidence or because evidence suggests that desirable and undesirable effects are closely balanced

1. To rate individual studies, a scale based on Scottish Intercollegiate Guideline Network (SIGN) is used.
2. The body of evidence quality ratings is defined by Grading of Recommendations Assessment, Development and Evaluation (GRADE). GRADE is a systematic approach to grading the strength of the total body of evidence that is available to support recommendations on a specific clinical management issue.
3. Key recommendations for care are defined by GRADE.

Document Overview

Document Title: Posterior Vitreous Detachment, Retinal Breaks, and Lattice Degeneration

Authoring Society: American Academy of Ophthalmology

Document Publication Date: Feb 7, 2025

Page Last Reviewed/Updated: May 5, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: www.aaojournal.org/article/S0161-6420(24)00787-5/fulltext

Source Citation: Kim SJ, Bailey ST, Kovach JL, Lim JI, Vemulakonda GA, Ying GS, Flaxel CJ; American Academy of Ophthalmology Preferred Practice Pattern Retina/Vitreous Committee. Posterior Vitreous Detachment, Retinal Breaks, and Lattice Degeneration Preferred Practice Pattern®. Ophthalmology. 2025 Feb 7:S0161-6420(24)00787-5. doi: 10.1016/j.ophtha.2024.12.023. Epub ahead of print. PMID: 39918519.

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Document Objectives: Identify patients at risk of developing a rhegmatogenous retinal detachment. Examine symptomatic patients who have an acute PVD to detect and treat associated retinal breaks or tears. Recognize the evolution of retinal breaks and lattice degeneration. Manage patients at high risk of developing retinal detachment. Educate high-risk patients about symptoms of PVD, retinal breaks, and retinal detachments as well as the need for periodic follow-up. Discuss treatment options available for VMT. Recognize the potential side effects of treatment of VMT

Scope: Assessment and Screening, Diagnosis, Management

Diseases/Conditions (MeSH)

D012163 - Retinal Detachment

D020255 - Vitreous Detachment

D012163 - Retinal Detachment

D020255 - Vitreous Detachment

Keywords: Lattice Degeneration, Posterior Vitreous Detachment, Retinal Breaks, vision loss

Inclusion Criteria: Adult, Older Adult

Health Care Settings: Ambulatory, Outpatient

Intended Users: Nurse, Nurse Practitioner, Optometrist, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Supplemental Methodology Resource: Data Supplement

Number of Source Documents: 112

Literature Search Start Date: Sunday, April 1, 2018

Literature Search End Date: Saturday, June 1, 2019

Includes peer/external review process?: Yes

Includes public comment process?: No

Methodologist involvement?: Yes

Patient involvement?: No

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: No