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Retinal detachment
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Retinal detachment

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    Retinal detachment Retinal detachment Presentation Transcript

    • Retinal Detachment (RD)
      By: Hamza J. AlGhamdi
    • Objectives

      1
      What??
      types
      2
      rhegmatogenous
      3
      4
      tractional
      5
      exudative
      6
      Clinical Features
      7
      cont…… with Salem
    • What is RD?
      cleavage in the plane between the neurosensory retina and the retinal pigment epithelium(RPE)
    • What??
      anatomy
    • 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
    • Types
    • 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
    • rhegmatogenous
    • rhegmatogenous
    • Your own footer
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      Pathogenesis of ocular damage by blunt trauma;
    • Types
    • 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
    • Traumatic tractional retinal detachment.
      (a) Penetrating injury resulting in vitreous prolapse and intraocular haemorrhage;
    • Traumatic tractional retinal detachment.
      (b) subsequent vitreoretinal proliferation and traction resulting
      in retinal detachment
    • Tractional retinal detachment associated with anteroposterior
      and bridging traction
    • Types
    • 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
    • Clinical features
    • 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)
    • 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
    • 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)
    • 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
    • Imaging Studies
      OCT
      B scan ultrasound
    • THANK YOU!