8/26/2023 0 Comments Detached retina photo![]() Ask about history of prior retinal detachment, retinal tears, and any prior ocular procedures. ![]() When a possible detachment is suspected, the presence or absence of the above symptoms should be documented. Other rare but more serious conditions such as choroidal tumors can be responsible for exudative retinal detachments too.Įvery patient encounter should begin with a history of present illness from the patient. Inflammatory conditions such as uveitis are the most common conditions responsible for this type of retinal detachment. They commonly grow in response to proliferative vitreoretinopathies, most notably diabetic retinopathy.(5) ExudativeĮxudative retinal detachment occurs due to an underlying condition causing buildup of fluid (exudate) between the neurosensory retina (photoreceptor layer) and the retinal pigment epithelium (RPE). Vitreous membranes are usually gliotic, fibrous, vascular, or a combination. No tears or holes are present in this type of retinal detachment. Tractional retinal detachment occurs when vitreous membranes pull on the retina separating it from the RPE. These full-thickness breaks, most commonly due to and held open by vitreoretinal traction, allow fluid from the liquified vitreous to move under the neurosensory retina and further separate it from the retinal pigment epithelium. It affects approximately 0.007-0.018% of the population yearly.(4) Rhegma means “break” in Greek, and these retinal detachments are due to full-thickness breaks in the retina. Rhegmatogenous retinal detachment (RRD) is the most common form of retinal detachment. These include rhegmatogenous retinal detachments, tractional retinal detachments, and exudative retinal detachments. However, in the simplest terminology, there are three primary forms of retinal detachment. There are many classification schemes for retinal detachment. The choroid is a vascular layer immediately posterior to the RPE which provides blood to the outer layers of the retina (the inner layers of retina supplied by branches of the central retinal artery). It recycles vitamin A for use by the retina in the visual cycle, and it keeps fluid from accumulating underneath the retina. It is responsible for nourishing the retina. The retinal pigment epithelium is between the retina and the choroid. Also, the vitreous breaks down and liquefies as we age.Įxternal and posterior to the retina are the retinal pigment epithelium (RPE) and the choroid. It comprises 80% of the volume of the eye and is responsible for providing mechanical support for our eyes during development.(3) However, there is little evidence of a functional purpose of the vitreous after our eyes have fully developed. Think of the vitreous as clear jelly inside the eye comprised of type II collagen and hyaluronic acid. Internal and anterior to the retina is the vitreous. This area of high photoreceptor density is important in retinal detachment as its condition dictates the prognosis of the disease. More specifically, the highest proportion of photoreceptors is in a central 1.5mm zone called the fovea. The macula has a high concentration of photoreceptors and is responsible for capturing central vision. The central portion of the retina is the macula. ![]() It is bordered anteriorly by the vitreous and posteriorly by the choroid. The retina is comprised of photoreceptors, neurons, and support cells. It is a thin layer that coats the internal border of the posterior eye. Think of the retina as the film of the camera.
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