Retinal detachment

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Retinal detachment

  1. 1. Retinal Detachment (RD)<br />By: Hamza J. AlGhamdi<br />
  2. 2. Objectives<br />✓<br />1<br />What??<br />types<br />2<br />rhegmatogenous<br />3<br />4<br />tractional<br />5<br />exudative<br />6<br />Clinical Features<br />7<br />cont…… with Salem<br />
  3. 3. What is RD?<br />cleavage in the plane between the neurosensory retina and the retinal pigment epithelium(RPE)<br />
  4. 4. What??<br />anatomy<br />
  5. 5. pathophysiology<br />How??<br />tTraction from inflammatory or vascular fibrous membranes on the surface of the retina, which tether to the vitreous<br />tExudation of material into the subretinal space from retinal vessels such as in hypertension, central retinal venous occlusion, vasculitis, or papilledema<br />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)<br />3<br />2<br />1 <br />
  6. 6. Types<br />
  7. 7. most common type of RD<br />caused by a tear or hole in the neurosensory retina, allowing fluid from the vitreous to pass into the subretinalspace<br /> tears may be caused by posterior vitreous detachment (PVD), degenerative retinal changes, trauma or iatrogenically<br />incidence increases with advancing age, and more likely to occur spontaneously in high myopes, or after ocular surgery / trauma<br />Location of the break varies according to the type:<br />E.g. Horseshoe tear >>> superotemporal<br />rhegmatogenous<br />
  8. 8. rhegmatogenous<br />
  9. 9. rhegmatogenous<br />
  10. 10.
  11. 11. Your own footer<br />Your Logo<br />Pathogenesis of ocular damage by blunt trauma;<br />
  12. 12. Types<br />
  13. 13. caused by traction (due to vitreal, epiretinal or subretinal membrane) pulling the neurosensory retina away from the underlying RPE<br />found in conditions such as diabetic retinopathy, CRVO, sickle cell disease, retinopathy of prematurity (ROP), and ocular trauma<br />Proliferative vitreoretinopathy is a complication of rhegmatogenous RD and is the most common cause of failure of surgical repair.<br />tractional<br />
  14. 14.
  15. 15. Traumatic tractional retinal detachment.<br />(a) Penetrating injury resulting in vitreous prolapse and intraocular haemorrhage;<br />
  16. 16. Traumatic tractional retinal detachment.<br />(b) subsequent vitreoretinal proliferation and traction resulting<br />in retinal detachment<br />
  17. 17. Tractional retinal detachment associated with anteroposterior<br />and bridging traction<br />
  18. 18.
  19. 19. Types<br />
  20. 20. caused by damage to the RPE resulting in fluid accumulation in the subretinal space<br />main causes are intraocular tumours, posterior uveitis, central serous retinopathy<br />exudative<br />
  21. 21.
  22. 22. Clinical features<br />
  23. 23. sudden onset<br />flashes of light<br />due to mechanical stimulation of the retinal photoreceptors<br />floaters<br />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)<br />
  24. 24. curtain of blackness / peripheral field loss<br />darkness in one field of vision when the retina detaches in that area<br />loss of central vision<br />visual acuity dramatically drops if the macula becomes detached<br />
  25. 25. decreased lOP (usually 4-5 mmHg lower than the other, normal eye)<br />ophthalmoscopy: detached retina is grey with surface blood vessels, loss of red reflex<br />± relative afferent pupillary defect (RAPD)<br />
  26. 26.
  27. 27. not necessary or indicated to assist the diagnoses retinal detachment<br />If the retina cannot be visualized because of corneal changes, cataracts, or hemorrhage, ultrasonography is necessary.<br />Imaging Studies<br />
  28. 28. Imaging Studies<br />OCT<br /> B scan ultrasound<br />
  29. 29. THANK YOU!<br />

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