Retinal detachment can occur when there is a separation between the neurosensory retina and the retinal pigment epithelium. The most common type is rhegmatogenous retinal detachment, which is caused by a tear or hole in the neurosensory retina that allows fluid to pass into the subretinal space. Tractional retinal detachment is caused by traction from membranes pulling on the retina, which can occur in conditions like diabetic retinopathy. Exudative retinal detachment is caused by fluid accumulation in the subretinal space due to damage to the retinal pigment epithelium. Symptoms of retinal detachment include flashes of light, floaters, curtain-like vision loss, and decreased vision.

1. Retinal Detachment (RD) By: Hamza J. AlGhamdi

2. Objectives ✓ 1 What?? types 2 rhegmatogenous 3 4 tractional 5 exudative 6 Clinical Features 7 cont…… with Salem

3. What is RD? cleavage in the plane between the neurosensory retina and the retinal pigment epithelium(RPE)

4. What?? anatomy

5. pathophysiology How?? tTraction from inflammatory or vascular fibrous membranes on the surface of the retina, which tether to the vitreous tExudation of material into the subretinal space from retinal vessels such as in hypertension, central retinal venous occlusion, vasculitis, or papilledema A hole, tear, or break in the neuronal layer allowing fluid from the vitreous cavity to seep in between and separate sensory and RPE layers (ie, rhegmatogenous RD) 3 2 1

6. Types

7. most common type of RD caused by a tear or hole in the neurosensory retina, allowing fluid from the vitreous to pass into the subretinalspace tears may be caused by posterior vitreous detachment (PVD), degenerative retinal changes, trauma or iatrogenically incidence increases with advancing age, and more likely to occur spontaneously in high myopes, or after ocular surgery / trauma Location of the break varies according to the type: E.g. Horseshoe tear >>> superotemporal rhegmatogenous

8. rhegmatogenous

9. rhegmatogenous

11. Your own footer Your Logo Pathogenesis of ocular damage by blunt trauma;

12. Types

13. caused by traction (due to vitreal, epiretinal or subretinal membrane) pulling the neurosensory retina away from the underlying RPE found in conditions such as diabetic retinopathy, CRVO, sickle cell disease, retinopathy of prematurity (ROP), and ocular trauma Proliferative vitreoretinopathy is a complication of rhegmatogenous RD and is the most common cause of failure of surgical repair. tractional

15. Traumatic tractional retinal detachment. (a) Penetrating injury resulting in vitreous prolapse and intraocular haemorrhage;

16. Traumatic tractional retinal detachment. (b) subsequent vitreoretinal proliferation and traction resulting in retinal detachment

17. Tractional retinal detachment associated with anteroposterior and bridging traction

19. Types

20. caused by damage to the RPE resulting in fluid accumulation in the subretinal space main causes are intraocular tumours, posterior uveitis, central serous retinopathy exudative

22. Clinical features

23. sudden onset flashes of light due to mechanical stimulation of the retinal photoreceptors floaters hazy spots in the line of vision which move with eye position, due to drops of blood in the vitreous (blood vessels tear as the retina tears)

24. curtain of blackness / peripheral field loss darkness in one field of vision when the retina detaches in that area loss of central vision visual acuity dramatically drops if the macula becomes detached

25. decreased lOP (usually 4-5 mmHg lower than the other, normal eye) ophthalmoscopy: detached retina is grey with surface blood vessels, loss of red reflex ± relative afferent pupillary defect (RAPD)

27. not necessary or indicated to assist the diagnoses retinal detachment If the retina cannot be visualized because of corneal changes, cataracts, or hemorrhage, ultrasonography is necessary. Imaging Studies

28. Imaging Studies OCT B scan ultrasound

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