A 27 year old, presented with a complaint of 2 years of gradual vision loss in his left eye. His best-corrected visual acuity was logMAR 1.30 (approximate Snellen equivalent, 20/400) OS. Funny how patient's dilated fundoscopy revealed a maculaoff inferotemporal retinal detachment (RD) in the left eye. Two oval cystoid abnormalities were seen at the 3-o’clock and 4- o’clock meridian near the equator, and a retinal hole was visualized near the equator at approximately the 4-o’clock meridian giving rise to spectacle looking image.
image from JAMAOPHTHALMOLOGY
Retina is a sensitive part of our eye where the image of the things we see is sent to the brain. Retinal detachment is the separation of the pigment epithelium of the retina and the neurosensory retina. It is a vision-threatening condition that must be treated. Unless it is treated, it can cause vision loss. It is common in aged people, those with a previous retinal detachment in one eye, a family history of retinal detachment, extreme nearsightedness (myopia), previous eye surgery such as cataract removal, and previous severe eye injury. Common symptoms of RD are photopsia, mostly for Rhegmatogenous RD, and floaters are usually absent in tractional RD but present in exudative RD. Slow and progressive loss of visual field and, for exudative RD, vision loss can occur suddenly.
If any of these symptoms are present, we should check our vision, visual functions, and retina with fundus photography and optic coherence tomography. If no detachment is found, your doctor will ask you to visit again after a few days to check for any anatomical changes in the retina, if present.
Rhegmatogeneous
1 among 10,000 getting suffered from this type of RD and 10% of this are bilateral. Sub-retinal fluid, derived from the fluid vitreous get enter into the subretinal space through a retinal break. Rhegmatogenous RD may be traumatic or spontaneous. Most common cause of this type of RD are high myopia, trauma and peripheral retinal degeneration.
Tractional
Retina is being mechanically pulled away from its normal position by the contraction of scar tissue in the vitreous. This type is more common for those who have uncontrolled diabetes. Two important causes of tractional retinal detachment are proliferative retinopathies and penetrating ocular trauma.
Exudative
Choroid can gain entry to the subretinal space through the damaged RPE. Exudative RD may be due to choroidal tumors and inflammation. The retina may be pushed away by a neoplasm or accumulation of fluid beneath the retina following inflammatory or vascular lesions, ARMD, or trauma. Here, mostly no holes or tears appear in OCT diagnosis
Comments
Post a Comment