Retinal detachment

What it is

Retinal detachment is a cleavage in the plane between the neurosensory retina and the retinal pigmented epithelium, the RPE. It comes in three types: rhegmatogenous, which is the most common, tractional and exudative.

Causes and risk

• Rhegmatogenous: a break in the retina. The tears may be caused by PVD, by degenerative retinal changes, by trauma or iatrogenically, and one page puts the break down to vitreous detachment in myopes and older patients. The incidence increases with advancing age, in high myopes, and after ocular surgery or trauma.
• Tractional: fibrous bands, as from proliferative diabetic retinopathy, pull the neurosensory retina away from the underlying RPE. It is found in diabetic retinopathy, CRVO, sickle cell disease, ROP and ocular trauma.
• Exudative: damage to the RPE, whether inflammation or neoplasia affecting its function, results in fluid accumulation in the subretinal space. The main causes are intraocular tumors, posterior uveitis and central serous retinopathy.

Retinal detachment is listed among the eye complications of sickle cell disease, along with hemorrhage, blindness and retinopathy, and among the complications of retinopathy of prematurity, along with fibrosis and blindness.