Retinal Detachment Flashcards
What is the potential space between the neural layer of retina and RPE called?
Subretinal space
When does the potential space between the 2 layers of the retina fuse?
Early foetal life
The RPE attaches to the choroid via a basement membrane called…
Bruch’s membrane
The neural layer is only attached firmly at…
The optic nerve head and anteriorly at its termination the Ora serrata
What is retinal detachment?
Holes/ tears in the retina allowing fluid to separate the sensory retina from the RPE
If a break is identified before detachment occurs what can be done?
Cryo/ laser retinoplexy may be preventative
Is retinal detachment a reversible cause of visual loss?
Yes provided it is recognised and treated before macula affected.
If left untreated and symptomatic, retinal detachment will lead to permanent visual loss
What types of retinal detachment are there?
1) Rhegmatogenous - tear in retina causes fluid to pass from vitreous space in subretinal space
2) Exudative - detachment without a tear e.g HTN, vasculitis, tumours, macular degeneration conditions
3) tractional - pulling on retina e.g proliferation retinopathy
What risk factors are there?
Age Previous surgery for cataracts Myopia Eye trauma e.g in boxing Diabetic retinopathy FH Previous history of retinal break in either eye
What symptoms are associated with retinal detachment?
4 Fs
New onset floaters or flashes
Field loss - sudden onset, painless and progressive, curtain or shadow progression to centre
Fall in acuity
In superior detachments, visual field loss is…
Inferior
What do floaters or flashes signify?
Pigment cells entering the vitreous space or traction on the retina
If the macula is involved, what kind of visual loss occurs?
Central vision loss
What is RD more common in myopic people?
Tend to have thinner retina
In RD, what may be seen on examination?
Peripheral visual fields reduced
Central acuity reduced to hand movements of macula detached
Swinging light test - relative afferent pupillary defect if optic nerve involved
Fundoscopy - red reflex lost, retinal folds appearing as pale, opaque, wrinkled
Slit lamp - pigment cells, vitreous haemorrhage
