Intravitreal ocriplasmin can produce acute visual acuity changes with widespread subretinal fluid and outer retinal ellipsoid zone hyporeflectivity on spectral domain optical coherence tomography. The overall acute and long-term safety profile of ocriplasmin remains unknown.

Retinal detachment is a potentially blinding condition. It is caused by separation of neurosensory retina from the underlying retinal pigment epithelium. Despite treatment advances, functional results remain poor (with only 42% achieving 6/12 vision and only 28% if the macula is involved). There are three distinct types of retinal detachment: rhegmatogenous (RRD), tractional and exudative. For the purpose of this chapter we will focus on RRD.RRD demonstrates wide geographical variation with incidence reported between 6.3 and 17.9 per 100, 000¹ with 7300 new cases estimated annually in the UK² . Risk factors include myopia, increasing age and certain vitreoretinal conditions. Horseshoe tears, giant tears and round holes have been shown the most common along with lattice degeneration .Vitreoretinal traction is responsible for most RRD. As the vitreous becomes syneretic (liquefied) with age, a posterior vitreous detachment (PVD) occurs. In most cases, the vitreous separates from the retina without any sequelae. However, in certain eyes, strong vitreoretinal adhesions are present and the occurrence of a PVD can lead to a retinal tear; then, fluid from the liquefied vitreous can enter the sub-retinal space through the tear, leading to a retinal detachment.Several studies have investigated the epidemiology and risk factors associated with RRD.

We report two cases of combined hamatoma of the retina and retinal pigment epithelium (CHR-RPE), illustrated with ultrasonography, optical coherence tomography, fundus fluorescein angiography and indocyanine green angiography images. CHR-RPE could clinically mimic several other retinal conditions. Failure to distinguish it from serious malignancies such as choroidal melanoma or retinoblastoma has led to unnecessary enucleation in the past. Through these case reports and a review of literature, we show the diagnostic features of CHR-RPE, its key differential diagnoses and the management options.

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