A nationwide study on the incidence of rhegmatogenous retinal detachment in denmark, with emphasis on the risk of the fellow eye. A 30yearold, 26week pregnant female presented with cu. Depending on the mechanism of subretinal fluid accumulation, retinal detachments traditionally have been classified into rhegmatogenous, tractional, and exudative. The royal college of ophthalmologists retinal detachment data set 2011prof158. In general, the sooner a rhegmatogenous retinal detachment is repaired the better. In general, management includes sealing all retinal breaks and relieving all vitreous traction. Retinal detachments can be rhegmatogenous caused by a break in the retina.
Changes in iris perfusion following scleral buckle surgery for rhegmatogenous retinal detachment. Introduction learning outcomes epidemiology anatomy of the eye anatomy of the retina pathogenesis rhegmatogenous tractional exudative quiz symptoms signs and investigations treatment external internal prognosis quiz references. The early diagnosis of a retinal detachment is important because the rate of successful reattachment is higher and the visual results are better if a retinal detachment is repaired before the macula is. Hyaluronic acid in the vitreous holds water and keeps insoluble collagen fibrils dispersed in the gel matrix. Pdf advances in the treatment of rhegmatogenous retinal. New treatment modalities could be explored in a detach. Management of the macula in rhegmatogenous retinal. The three most important reattachment procedures are scleral buckling, pars plana vitrectomy. Intraoperative fundus photograph of a 62yearold woman who had a rhegmatogenous retinal detachment with a coexisting macular hole of 1month. Management, part 2 retina ophthalmic pearls l ast month, ophthalmic pearls discussed risk factors, features, and examination of rhegmatogenous retinal detachments rrd. Rhegmatogenous retinal detachment rrd is defined as the separation of the neurosensory retina from the retinal pigment epithelium rpe layer due to the presence of retinal breaks.
This month, the authors continue with a discussion of rrd management. Management of rhegmatogenous retinal detachment with coexistent macular hole in the era of internal limiting membrane peeling. Thirtyone consecutive patients 31 eyes with maculaoff retinal detachment, peripheral breaks and a coexisting macular hole were prospectively enrolled over a 3year period. Management of primary rhegmatogenous retinal detachment. Surgical management of unilateral rhegmatogenous retinal.
High myopia extreme nearsightedness advanced age family history of retinal tears or retinal detachment previous retinal detachment previous eye surgery such as cataract surgery. Management of cytomegalovirusrelated rhegmatogenous. To compare the outcomes of vitrectomy with or without internal limiting membrane peeling for rhegmatogenous retinal detachment and coexisting macular hole. Management of a rhegmatogenous retinal detachment in a. Detachment is more likely with advancing age because molecular breakdown and shrinkage of the. Anytime subretinal fluid accumulates in the space between the neurosensory retina and the underlying retinal pigment epithelium rpe, a retinal detachment occurs. Although retinal detachments are common, there is still some controversy on the optimal treatment options for different types and presentations of retinal detachment. Loss of retinal tension and permanent decrease in retinal. How to proceed rrds with superior breaks that threaten. The groups were compared for rates of retinal reattachment, visual improvement, and the occurrence of recurrent rhegmatogenous retinal detachment and any. Pdf management of rhegmatogenous retinal detachment with. It is to determine the configuration of the detachment as shallow, flat or bullous 51.
These included repeated pr, scleral buckling, vitrectomy with gas or silicone oil, and vitrectomy with scleral buckling. Reattachment can be achieved with a single pneumatic retinopexy procedure in 80% of cases and with. May be primary rhegmatogenous retinal detachment, secondary to traction, or exudative in nature. Management of cytomegalovirusrelated rhegmatogenous retinal detachments. Optimizing the treatment of rhegmatogenous retinal. Retinal detachment often is a preventable cause of vision loss. Rhegmatogenous retinal detachment a rhegmatogenous retinal detachment occurs due to a break in the retina called a retinal tear that allows fluid to pass from the vitreous space into the subretinal space between the sensory retina and the retinal pigment epithelium. Combined or sequential surgery for management of rhegmatogenous retinal detachment with macular holes. Retinal detachment occurs when subretinal fluid accumulates in the potential space between the neurosensory retina and the underlying retinal pigment epithelium rpe. Some of the common etiologies for tractional retinal detachment include diabetes, connective tissue disease, sickle cells and trauma. Awith aging, changes to hyaluronic acid cause pockets of liquefied vitreous, leaving the collagen. However, applying a sb during ppv may produce a risk of choroidal haemorrhage.
Clinical findings and management of rhegmatogenous retinal. The aim of the study was to evaluate the anatomical success of surgical management of primary rhegmatogenous retinal detachment rrd and to compare the anatomical outcomes from different. We discuss the case of a 49yearold soldier with a maculaon rhegmatogenous retinal detachment in sierra leone. A case is presented herein of rhegmatogenous retinal detachment occurring during pregnancy. Evaluation and management of sus pected retinal detachment. Retinal breaks are divided into three types holes, tears and dialyses. Although exudative retinal detachments have been well documented to occur during pregnancy, reports of rhegmatogenous retinal detachments occurring during pregnancy are rare. Paper ii reoperation for rhegmatogenous retinal detachment as quality indicator for disease management. Recognition of symptoms and awareness of the risk factors for retinal detachment may help in making speedy referrals and saving vision. The case highlights the challenge of accessing visually preserving ophthalmic specialist care in subsaharan africa ssa for vitreoretinal vr disease.
Some of the challenges arising from this uncommon clinical scenario are discussed. Retinal detachment a self directed learning package for medical students. With it, you get a hole, tear, or break in the retina. Rhegmatogenous retinal detachment is the most common type. The development of rhegmatogenous rd is a consequence of vitreoretinal traction such as a posterior vitreous detachment leading to the development of one or more breaks in the retina. Surgical techniques for repairing rrd have advanced considerably since the days of jules gonin in the early 20th century, however. Management of rhegmatogenous retinal detachment in a full. An acute or progressive condition in which the neuroretina separates from the retinal pigment epithelium with accumulation of sub retinal fluid and loss of retinal function. Although rhegmatogenous retinal detachment rrd surgery achieves success rates of 80% or over, improvement in success rates has been minimal in. Horizontal time domain oct left to right, 10mm scan of the left eye captures the macular hole in the detached retina but not the underlying retinal pigment epithelium. Rhegmatogenous retinal detachments rrd with inferior breaks are usually treated by scleral buckling sb or pars plana vitrectomy ppv or a combination of both methods. The authors would like to present an unusual case of unilateral retinal detachment, phacodonesis, dense cataract and ocular coloboma in a 7yearold indian muslim boy with noonan syndrome.
Rhegmatogenous retinal detachment can lead to profound loss of vision. Management of rhegmatogenous retinal detachment without detectable breaks. Changes in iris perfusion following scleral buckle surgery. Primary rhegmatogenous retinal detachment is caused by one or more retinal breaks, usually with concomitant vitreous traction. Management of rhegmatogenous retinal detachment with. Usually, these breaks are caused by vitreous traction on the retina and allow the accumulation of fluid in the subretinal space. Management of a rhegmatogenous retinal detachment in a low. Fluid can then pass from the vitreous cavity through these retinal breaks into the subretinal space, which extends the detachment once the amount of incoming. Pdf management of rhegmatogenous retinal detachment. One hundred thirtyfour consecutive eyes with rhegmatogenous retinal detachment involving the macula were evaluated with reference to the effectiveness of systemic steroids in preventing choroidal detachment. To describe the management of a rhegmatogenous retinal detachment rrd in a pregnant patient. A tractional retinal detachment occurs when pre retinal fibrovascular or fibrotic membrane pulls the retina anteriorly causing detachment.
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