scholarly journals The fellow eye of patients with phakic rhegmatogenous retinal detachment from atrophic holes of lattice degeneration without posterior vitreous detachment

2004 ◽  
Vol 88 (11) ◽  
pp. 1400-1402 ◽  
Author(s):  
C R Gonzales
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Posterior Vitreous Detachment ◽  
Fellow Eye ◽  
Vitreous Detachment ◽  
Lattice Degeneration

Rhegmatogenous Retinal Detachment: Pathophysiology and Risk Factors

2019 ◽  
pp. 138-141
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Retinal Detachment ◽  
Cataract Surgery ◽  
Rhegmatogenous Retinal Detachment ◽  
Posterior Vitreous Detachment ◽  
Retinal Diseases ◽  
Retinal Tears ◽  
Lattice Degeneration ◽  
Major Factors

Rhegmatogenous retinal detachment is one of the most important retinal diseases requiring urgent surgical treatment. To be aware of the pathophysiology of the disease and to know the risk factors; it is crucial to prevent the development of the disease or overcome the complications that may arise and understand the surgical treatment principles. Major factors in the development of RRD: retinal tears, vitreous liquefaction, and detachment, traction on the retina surface. Myopia, previous cataract surgery, trauma, posterior vitreous detachment, lattice degeneration are the most important risk factors.

Rhegmatogenous Retinal Detachment, Pathophysiology and Risk Factors

2019 ◽  
pp. 138-141
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Retinal Detachment ◽  
Cataract Surgery ◽  
Rhegmatogenous Retinal Detachment ◽  
Posterior Vitreous Detachment ◽  
Retinal Diseases ◽  
Retinal Tears ◽  
Lattice Degeneration ◽  
Major Factors

Rhegmatogenous retinal detachment is one of the most important retinal diseases requiring urgent surgical treatment. To be aware of the pathophysiology of the disease and to know the risk factors; it is crucial to prevent the development of the disease or overcome the complications that may arise and understand the surgical treatment principles. Major factors in the development of RRD: retinal tears, vitreous liquefaction, and detachment, traction on the retina surface. Myopia, previous cataract surgery, trauma, posterior vitreous detachment, lattice degeneration are the most important risk factors.

scholarly journals Incidence and Risk Factors of Iatrogenic Retinal Breaks: 20-Gauge versus 25-Gauge Vitrectomy for Idiopathic Macular Hole Repair

2020 ◽  
Vol 2020 ◽  
pp. 1-4 ◽  
Author(s):  
Norio Fujiwara ◽  
Goji Tomita ◽  
Fumihiko Yagi
Keyword(s):  
Retinal Detachment ◽  
Macular Hole ◽  
Gauge Group ◽  
Posterior Vitreous Detachment ◽  
Idiopathic Macular Hole ◽  
Gauge Groups ◽  
Vitreous Detachment ◽  
Retinal Breaks ◽  
Lattice Degeneration ◽  
25 Gauge Vitrectomy

Purpose. We compared the incidences of iatrogenic retinal breaks and postoperative retinal detachment between eyes that underwent 20-gauge vitrectomy and those that underwent 25-gauge vitrectomy for idiopathic macular hole repair. Methods. This retrospective nonrandomized consecutive observational case series included 185 eyes of 183 patients (130 eyes of 129 patients and 55 eyes of 54 patients in the 20- and 25-gauge groups, respectively). We assessed the relationship between the incidence of retinal breaks and postoperative retinal detachment and related this to posterior vitreous detachment and lattice degeneration. Results. The incidences of iatrogenic retinal breaks were 36.9% and 12.7% in the 20-gauge and 25-gauge groups, respectively. These groups did not differ in their respective frequencies of posterior vitreous detachment (the 20-gauge group: 31.5% and the 25-gauge group: 27.3%) and lattice degeneration (the 20-gauge group: 14.6% and the 25-gauge group: 7.3%). Among eyes without lattice degeneration, the 20-gauge group showed a higher incidence of iatrogenic retinal breaks than the 25-gauge group. However, among the eyes with lattice degeneration, the frequency of retinal breaks did not differ between the two surgery types, and four cases of postoperative retinal detachment were reported in both groups. Conclusions. The incidence of retinal breaks related to idiopathic macular hole surgery is higher among patients undergoing 20-gauge vitrectomy than among those undergoing 25-gauge vitrectomy. Posterior vitreous detachment and lattice degeneration are associated with considerably increased incidences of retinal break.

Evaluation of hyaloid–retinal relationship during triamcinolone-assisted vitrectomy for primary rhegmatogenous retinal detachment

2018 ◽  
Vol 28 (5) ◽  
pp. 607-613 ◽  
Author(s):  
Dheepak Sundar ◽  
Brijesh Takkar ◽  
Pradeep Venkatesh ◽  
Rohan Chawla ◽  
Shreyas Temkar ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Proliferative Vitreoretinopathy ◽  
Rhegmatogenous Retinal Detachment ◽  
Posterior Vitreous Detachment ◽  
Vitreous Surgery ◽  
Vitreous Detachment ◽  
Retinal Breaks ◽  
Vitreoretinal Degeneration ◽  
Type 3

Aims: To determine hyaloid–retinal relationship in primary rhegmatogenous retinal detachment during vitreous surgery. Methods: This is a prospective, interventional study of patients (n = 72) undergoing triamcinolone-assisted 25G vitreous surgery for primary rhegmatogenous retinal detachment. Hyaloid–retinal relationship was noted intraoperatively to identify regions and patterns of firm attachment and was classified into subgroups. Analysis was done to determine association between hyaloid–retinal relationship patterns and preoperative findings: posterior vitreous detachment, proliferative vitreoretinopathy, type of retinal tear, the presence of peripheral degenerations, and postoperative outcomes. Results: Three patterns of hyaloid–retinal relationship were identified: type1 (complete absence of posterior vitreous detachment (21%)), type 2 (incomplete posterior vitreous detachment (47%)) and type 3 (complete posterior vitreous detachment (32%)). Posterior vitreous detachment in some form was present in 84% of the cases with retinal tears as the causative break but none of the cases with retinal holes (p < 0.001). None of the cases with vitreoretinal degeneration had complete posterior vitreous detachment (p = 0.001). 69% of proliferative vitreoretinopathy–C cases had type 1 hyaloid–retinal relationship as compared to 11% cases with no proliferative vitreoretinopathy (p < 0.001). Proliferative vitreoretinopathy-related anatomical failure was seen in 7.5%, and 80% of these eyes with recurrent RD had type 1 hyaloid–retinal relationship (p<0.001). Nearly half the patients diagnosed as complete posterior vitreous detachment preoperatively were found to have incomplete posterior vitreous detachment intraoperatively. Conclusions: Majority of the cases with rhegmatogenous retinal detachment have some form of strong vitreoretinal adhesion. Hyaloid–retinal relationship varies with types of retinal breaks, retinal degeneration, and proliferative vitreoretinopathy. Intraoperative hyaloid–retinal relationship is frequently different from that assessed before surgery and the proposed classification may improve surgical decision making and prognostication.

Evaluation and Management

2009 ◽  
Author(s):  
Daniel A. Brinton ◽  
Charles P. Wilkinson
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Posterior Vitreous Detachment ◽  
Anterior Segment ◽  
Careful Examination ◽  
Ocular Motility ◽  
Vitreous Detachment ◽  
Indirect Ophthalmoscopy ◽  
Field Defect

Evaluation of a patient for retinal detachment includes a thorough history and a complete ocular exam, including measurement of visual acuity, external examination, ocular motility testing, testing of pupillary reactions, anterior-segment biomicroscopy, tonometry, and binocular indirect ophthalmoscopy with scleral depression. Posterior-segment biomicroscopy, perimetry, and ultrasonography are also sometimes required. Rhegmatogenous retinal detachment is a diagnosis generally made by clinical examination of the retina alone, but a full history, ocular examination, and sometimes selected ancillary tests are also important parts of the evaluation (Figure 4–1). The symptoms of retinal detachment include fl ashes of light, new floaters, visual Field defect, decreased visual acuity, metamorphopsia, and rarely, defective color vision. The perception of light fl ashes, or photopsia, is due to the production of phosphenes by pathophysiologic stimulation of the retina. The retina is activated by light but is also capable of responding to mechanical disturbances. In fact, the most common cause of light fl ashes is posterior vitreous detachment. As the vitreous separates from the retinal surface, the retina is disturbed mechanically, stimulating a sensation of light. This perception is more marked if there are focal vitreoretinal adhesions. Generally, vitreous separation is benign and may almost be regarded as normal in the senescent eye. In approximately 12% of symptomatic posterior vitreous detachments, however, a careful search of the periphery reveals a tear of the retina. If the fl ashes are associated with floaters, it is wise to assume that a retinal tear exists, until proved otherwise. These symptoms demand a prompt and careful examination of the periphery with binocular indirect ophthalmoscopy and scleral indentation. The patient’s localization of the photopsia is of little value in predicting the location of the vitreoretinal pathology. If no breaks are evident in the first examination after symptomatic vitreous detachment, they rarely appear at a later date. If there is no associated hemorrhage or other pathologic condition, the patient needs counseling only. However, if pigment or blood is detected in the vitreous, a follow-up examination is often required. It is prudent to forewarn patients about the symptoms of retinal detachment. Flashes alone or floaters alone are less significant than if they occur together, in which case they are more likely to be associated with a retinal break.

Pathogenesis, Epidemiology, and Natural Course of Retinal Detachment

2009 ◽  
Author(s):  
Daniel A. Brinton ◽  
Charles P. Wilkinson
Keyword(s):  
Diabetic Retinopathy ◽  
Retinal Detachment ◽  
Proliferative Diabetic Retinopathy ◽  
Posterior Vitreous Detachment ◽  
Subretinal Fluid ◽  
Vitreous Cavity ◽  
Subretinal Space ◽  
Retinal Break ◽  
Vitreous Detachment ◽  
Pass Through

Retinal detachment does not result from a single, specific disease; rather, numerous disease processes can result in the presence of subretinal fluid. The three general categories of retinal detachments are termed rhegmatogenous, exudative, and tractional. Rhegmatogenous detachments are sometimes referred to as primary detachments, while both exudative and tractional detachments are called secondary or nonrhegmatogenous detachments. The three types of retinal detachments are not mutually exclusive. For example, detachments associated with proliferative vitreoretinopathy or proliferative diabetic retinopathy may exhibit both rhegmatogenous and tractional features. However, excluding the section on differential diagnosis in Chapter 5, the scope of this book is limited to rhegmatogenous retinal detachments. Accordingly, throughout the book, the term retinal detachment refers to the rhegmatogenous type, unless another type is specifically mentioned. Rhegmatogenous detachments (from the Greek rhegma, meaning rent, rupture, or fissure) are the most common form of retinal detachment. They are caused by a break in the retina through which fluid passes from the vitreous cavity into the subretinal space. The responsible break(s) can be identified preoperatively in more than 90% of cases, but occasionally the presence of a minute, unseen break must be assumed. Exudative detachments, also called serous detachments, are due to an associated problem that produces subretinal fluid without a retinal break. This underlying problem usually involves the choroid as a tumor or an inflammatory disorder. Tractional detachments occur when pathologic vitreoretinal adhesions or membranes mechanically pull the retina away from the pigment epithelium without a retinal break. The most common causes include proliferative diabetic retinopathy, cicatricial retinopathy of prematurity, proliferative sickle retinopathy, and penetrating trauma. Retinal breaks may subsequently develop, resulting in a combined tractional and rhegmatogenous detachment. The essential requirements for a rhegmatogenous retinal detachment include a retinal break and low-viscosity vitreous liquids capable of passing through the break into the subretinal space. Vitreous changes usually precede development of important defects in the retina. The usual pathologic sequence causing retinal detachment is vitreous liquefaction followed by a posterior vitreous detachment (PVD) that causes traction at the site of significant vitreoretinal adhesion with a subsequent retinal tear. Fluids from the vitreous cavity then pass through the tear into the subretinal space (Figure 2–1), augmented by currents within the vitreous cavity caused by rotary eye movements. Although a total PVD is usually seen, many detachments occur with partial vitreous detachment, and evidence of posterior vitreous detachment may not be seen.

Peripheral Retinal Degenerations with Risk of Rhegmatogenous Retinal Detachment and Management

2019 ◽  
pp. 142-146
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Peripheral Retina ◽  
Retinal Degenerations ◽  
Lattice Degeneration

Retinal degenerations are common lesions involving the peripheral retina, and most of them are clinically insignificant. Lattice degeneration, cystic retinal tuft, zonular traction tuft, snail track degeneration, degenerative retinoschisis, white without pressure lesions can result in a rhegmatogenous retinal detachment. In this paper, we aimed to discuss peripheric retinal degenerations that predispose retinal detachment and the treatments for them.

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