Retinal Detachment - An Update of the Disease and Its Epidemiology - A Discussion Based on Research and Clinical Experience at the Prince Charles Eye Unit, Windsor, England

Abstract

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.

Management of Rhegmatogenous Retinal detachment with Buckle Sclera and Cryoretinopexcy

“…6, -8,15,20,23 follow-up assessed is visus progress, intraocular pressure, silicon oil condition (this condition can be seen 6-12 months postoperatively), retina attached or not and also need to assess the optical condition of the patient to assess the optic nerve. 1,15,16,21,22 The prognosis in this patient is quo ad vitam dubia ad bonam. If the patient presents with ablatio retina rhegmatogen with initial visus 1/60 to 5/60.…”

“…These fundus photo shots are also adjusted for break locations with Linchoff Rules 2 based on the American Academy of Ophthalmology, diagnostic and advanced management. 5,6,9,10,[15][16][17][18][19][20][21][22][23] Scleral buckling technique can be chosen because of the break position found and the retinal loss of 1-2 quadrants. According to Martinez et al, added pars plana vitrectomy, this operative combination is performed to reduce the risk of failure or recurrent retinal ablatio and a better prognosis than buckle sclera alone.…”