Misdirected aqueous flow in rhegmatogenous retinal detachment: A pathophysiology update

Tabibian, David; Hoogewoud, Florence; Mavrakanas, Nikolaos; Schutz, James Scott

doi:10.1016/j.survophthal.2014.07.002

Cited by 14 publications

(12 citation statements)

References 89 publications

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“…This mechanism, which is as a sort of aqueous misdirection from the posterior chamber to the SRS, explains, at least in part, the relative hypotony registered after RRD (Pederson & Cantrill ; Tabibian et al. ). In accordance with these evidences, our study showed IOP values significantly lower in the RRD eyes compared with the UE.…”

Section: Discussionmentioning

confidence: 98%

“…The separation of retinal pigment epithelium (RPE) from the neurosensory retina and the following accumulation of fluid in the sub‐retinal space (SRS) may be considered as the primum movens of scleral and conjunctival changes, since the SRFs permeate through the neighbouring tissues in the attempt to be drained (Tabibian et al. ). The SRF absorption mainly occurs through the RPE, which incessantly pumps fluids into the choroid (Pederson ; Pederson & Cantrill ; Chihara & Nao‐i ; Quintyn & Brasseur ; Tabibian et al.…”

Section: Discussionmentioning

confidence: 99%

“…The SRF absorption mainly occurs through the RPE, which incessantly pumps fluids into the choroid (Pederson ; Pederson & Cantrill ; Chihara & Nao‐i ; Quintyn & Brasseur ; Tabibian et al. ).…”

Section: Discussionmentioning

confidence: 99%

“…Nowadays, it is well established that SRF derive for the most part from vitreous, serum and retinal debris; however, it seems to contain also AH, which flows posteriorly through the vitreous to reach the SRS via retinal breaks (Pederson ; Pederson & Cantrill ; Quintyn & Brasseur ; Tabibian et al. ). The assumption that a continuous fluid flow in the SRS could not come from a limited volume of degenerated vitreous further supports the hypothesis that AH could be the major source replacing the drained SRF.…”

Section: Discussionmentioning

confidence: 99%

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Scleral and conjunctival features in patients with rhegmatogenous retinal detachment undergoing scleral buckling: an anterior segment optical coherence tomography and in vivo confocal microscopy study

Carpineto

Agnifili

Senatore

et al. 2019

Acta Ophthalmologica

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Purpose: To investigate the scleral and conjunctival features in patients with rhegmatogenous retinal detachment (RRD) undergoing scleral buckling (SB), using anterior segment optical coherence tomography (AS-OCT) and in vivo confocal microscopy (IVCM). Methods: Twenty RRD eyes were consecutively enrolled. AS-OCT was performed at RRD diagnosis (RRD-D) and day 1, week 1, month 1 and month 6 after SB to evaluate the sclera, in the affected and unaffected quadrants (AQ, UQ). IVCM was performed at RRD-D, and at month 1 and month 6, to evaluate the conjunctiva in AQ and UQ. The main outcomes were as follows: mean intra-scleral hypo-reflective spaces area (MIHSA) at AS-OCT; mean density and area of microcysts (MMD, MMA) at IVCM; and intra-ocular pressure (IOP). The relations between MIHSA, MMA, MMD and IOP were evaluated. Results: Rhegmatogenous retinal detachment-diagnosis (RRD-D) overall-mean intra-scleral hypo-reflective spaces (MISHA), -MMD and -MMA were significantly higher in affected eye (AE) compared with UE (p < 0.05) and in AQ compared with UQ (p < 0.05). After SB, overall-, AQ-and UQ-MISHA further increased (p < 0.05), whereas overall-MMD and -MMA did not change. At all follow-up, AQ and UQ parameters did not show significant differences between them. RRD-D IOP was 14.3 AE 2.8 and 15.5 AE 2.7 mmHg in the AE and UE, respectively (p < 0.05). After SB, week-1, month-1 and -6 IOP was significantly lower than RRD-D (p < 0.05). Rhegmatogenous retinal detachment-diagnosis (RRD-D), 1-and 6-month overall and AQ-MISHA and AQ-MMD negatively correlated with IOP (p < 0.05). Conclusion: Rhegmatogenous retinal detachment (RRD) and SB induced scleral and conjunctival changes that suggested an activation of fluid outflow through the entire unconventional aqueous humour pathway; these modifications may in part account for the relative hypotony after RRD and SB.Key words: anterior segment optical coherence tomography -in vivo confocal microscopy -intra-ocular pressure -rhegmatogenous retinal detachment -scleral buckling -unconventional aqueous humour outflow *Equally contributed to this work and share primary authorship.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Scleral and conjunctival features in patients with rhegmatogenous retinal detachment undergoing scleral buckling: an anterior segment optical coherence tomography and in vivo confocal microscopy study

Carpineto

Agnifili

Senatore

et al. 2019

Acta Ophthalmologica

View full text Add to dashboard Cite

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“…18 53 Intraocular currents from indirect trauma sufficient to create a fresh retinal tear must be even more forceful than those associated with normal ocular saccades and are usually accompanied by signs of trauma. Even though trivial indirect trauma is not sufficient to cause a retinal break in a normal eye, in cases with classic symptoms of a retinal tear occurring in close temporal association to a trauma, causal relationship is often attributed.…”

Section: Rhegmatogenous Retinal Detachmentmentioning

confidence: 99%