Rhegmatogenous Retinal Detachment
Retinal detachment is a condition in which the neurosensory retina is separated from the retinal pigment epithelium.
Rhegmatogenous Retinal Detachment:
What is Rhegmatogenous Retinal Detachment?
Rhegmatogenous retinal detachment is a separation of the neurosensory retina from the underlying retinal pigment epithelium. This separation is characterised by the presence of a retinal break in conjunction with vitreoretinal traction, which enables accumulation of liquid vitreous underneath the retina.
Symptoms of Rhegmatogenous Retinal Detachment:
Very brief flashes of light (photopsia) in the extreme peripheral (outside of center) part of vision
A sudden dramatic increase in the number of floaters
A ring of floaters or hairs just to the temporal side of the central vision
A dense shadow that starts in the peripheral vision and slowly progresses towards the central vision
The impression that a veil or curtain was drawn over the field of vision
Straight lines (scale, edge of the wall, road, etc.) that suddenly appear curved Central visual loss
Causes of Rhegmatogenous Retinal Detachment
Risk factors include the following:
Myopia
Previous cataract surgery
Ocular trauma
Lattice retinal degeneration
A family history of retinal detachment
Rhegmatogenous Retinal Detachment Prevention
Avoid direct and indirect injury to the eyes
Regular eye check up
Types of Rhegmatogenous Retinal Detachment
Fresh Retinal Detachment
Long standing retinal detachment characterized by proliferative vitreo retinopathy changes
- Grade A- diffuse vitreous haze and tobacco dust
- Grade B-wrinkling of inner retinal surface & decreased mobility of vitreous gel
- Grade C- rigid full thickness retinal folds with heavy vitreous condensation and strands
Rhegmatogenous Retinal Detachment Diagnosis
- Ophthalmoscopy preferably with indirect ophthalmoscope
- Fundus photography
- Ultrasound B scan
Rhegmatogenous Retinal Detachment Treatment
- Retinal laser photocoagulation and cryopexy
- Scleral buckle surgery
- Pneumatic retinopexy
- Vitrectomy surgery
Based on the aetiology and location of the tear, a variety of treatments are available for rhegmatogenous detachment. The retinal tears are repaired using laser or cryotherapy in these techniques. Silicone is placed on the sclera to create an indentation that pushes the retina inward, reducing vitreous tension on the retina. Subretinal fluid may be evacuated during this technique. Pneumatic retinopexy (gas-assisted retinal attachment) and vitrectomy are the additional therapy options. Retinal tears can be treated with cryopexy (scarring the retinal tear by freezing) or laser photocoagulation (using a green Argon, red Krypton, or Diode laser). Most cases of rhegmatogenous retinal detachment are successfully treated surgically.
It is possible to treat rhegmatogenous detachments caused by vitreoretinal tension by vitrectomy. Retinal detachment treatments like vitrectomy are becoming more common. Removing the vitreous gel and replacing it with a gas bubble (SF6 or C3F8 gas) or silicone oil are common procedures performed together during vitrectomy. After a vitrectomy, the resulting space is filled with either gas (SF6, C3F8 gas) or silicone oil (PDMS). Gas requires correct patient placement following surgery and is absorbed in a matter of weeks, whereas silicone oil remains in the eye for up to six months and must be withdrawn to prevent a myopic shift.