R.D.

BY:

MARWAN ABOUAMMOH

R.D.

Rhegmatogenous Tractional Exudative

1/10000 In aphakics: 1-3% Rhegmatogenous R.D. has 5% chance of

forming PVR

R.R.D. Vitreous liquifaction R. break Eye’s movement PVD, V-R traction

PVD Loss of hyaluronic acid 15% of acute PVD have a retinal tear 13-19% have vit. He PVD+hge= 70% with tears PVD+no hge= 2-4% with tears Weiss ring

Acute PVD: Examine preiphery Vit hge = rest, patching ou, examine later U/S

R.D. RISK FACTORS

1. Lattice & other peripheral degen.:1. 8% of pop.2. A cause of RD in 20-30%3. In RD with L.D.:

1. 30-45% atrophic holes2. 55-70% tear at the edge of L.D.

1. Dentate process, oral bay, pars plana island peripheral, cystoid degen., Paving stone degen.,

2. High myopia:>6D

3. Cataract surgery:More with PVD, ICCE>ECCE, Increased risk with P.C.otomy (1.3%), and vit.

Loss50% of R.D.’s in 1st yr.

4. Glaucoma > In pigment dispersion syndrome COAG > in R.D. patients(7% vs. 1%) Miotics & R.D.

5. R.D. in the fellow eye or FHx of R.D.

6. Trauma: retinal dialysis, giant tear

Symptoms:

Exam: don’t forget indentation

40-50% of all R.R.D. have > 1 break usually located 90 degrees from primary break.

Types of breaks: Horse-shoe tear Operculated hole Atrophic hole Dialysis

RRD ERD TRD

VITREOUS PIGMENT ± BLOOD

NO PIGMENT ± INFLAMMATORY CELLS

NO PIGMENT

FLUID FAIRLY STATIC DEPENDENT SHIFTING FLUID

LITTLE FLUID, NON SHIFTING

SHAPE CONVEX CORRUGATED

CONVEX SMOOTH

CONCAVE

RETINAL FEATURES

BREAKS ± DEGENERATION

NORMAL OR FEATURES OF UNDERLYING DISEASE

PRERETINAL FIBROSIS

CHRONIC R.D.

Retinal thinning

Demarcation line

Intraretinal cysts

PVR

CAUSES OF TRD

PRD

ROP

SCR

VMT

INCONTINENTIA PIGMENTI

RETINAL DYSPLASIA

PVR A B C

1-12 TYPE

ERD: Idiopathic

Coats disease Central serous chorioretinopathy Uveal effusion syndrome

Inflammatory Vogt-Koyanagi-Harada syndrome Syphilis Scleritis Sympathetic ophthalmia Other vasculitic entities (eg, rheumatoid arthritis, Wegener granulomatosis) Other uveitic conditions (eg, toxoplasmosis, cytomegalovirus [CMV] retinitis) Dengue fever Orbital pseudotumor Lymphomatoid granulomatosis

Congenital Nanophthalmos Colobomas of the optic nerve Familial exudative vitreoretinopathy

Neoplastic Choroidal melanoma Choroidal metastases Choroidal nevus Choroidal hemangioma Retinoblastoma Primary intraocular lymphoma

Iatrogenic Excessive panphotocoagulation Scleral buckling

Vascular factors Eclampsia Exudative age-related macular degeneration Chronic renal failure Hypertension