Retinal Detachment

Retinal detachment (RD) occurs when the retina, which is the neural tissue of the eye that sees, separates from its nutritional supply of the retinal pigment epithelium (RPE) and choroid. There are 3 different forms of retinal detachments:

1. Rhegmatogenous Retinal Detachment (most common form)
2. Tractional Retinal Detachment
3. Exudative Retinal Detachment.

A rhegmatogenous retinal detachment which is the most common form and often referred to just as a retinal detachment, arises from a retinal tear. Retinal tears develop either from trauma, hereditary eye diseases, or from natural aging such as those that develop after a posterior vitreous detachment. If not repaired, the retina is unable to function and begins degenerating due to the lack of nutrition, leading to blindness. Surgery is necessary to repair a rhegmatogenous detachment either by a scleral buckle, vitrectomy, or a combination of both.

A tractional retinal detachment is seen often with proliferative diabetic retinopathy or with proliferative vitreoretinopathy. It is the result of scar tissue that develops either from abnormal blood vessel growth or from proliferating tissue that pulls on the surface of the retina and causes the retina to separate from the underlying nutritive supply of the RPE and choroid. This leads to impaired function of the retina and blurred vision. Surgery is necessary, often times by vitrectomy with a membrane peel, to remove the scar tissue that is tractionally causing the retina to detach.

The last form is exudative retinal detachment. This is often times due to tumors or inflammatory disease processes resulting in fluid leakage arising from the RPE or choroid. The fluid leaks into the subretinal space and separates the retina from the RPE/choroid. Vision in this form of retinal detachment tends to be less impaired compared to the earlier two forms of retinal detachments due to fluid containing nutrients that are exuded from the RPE/choroid.