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Retinal detachments are divided into three main types based on their distinct causes. [6] Rhegmatogenous retinal detachment is caused by a tear or break in the retina. [6] [9] This allows vitreous humor, the fluid that normally sits in the center of the eye, to build up behind the retina.
The risk of retinal detachment is the greatest in the first 6 weeks following a vitreous detachment, but can occur over 3 months after the event.. The risk of retinal tears and detachment associated with vitreous detachment is higher in patients with myopic retinal degeneration, lattice degeneration, and a familial or personal history of previous retinal tears/detachment.
The presence of retinal tears with new onset of floaters was surprisingly high (14%; 95% confidence interval, 12–16%) as reported in a meta-analysis published as part of the Rational Clinical Examination Series in the Journal of the American Medical Association. [21]
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A tear in the retina can allow fluids from the eye to leak in behind the retina, which causes retinal detachment. When this occurs, blood from the retinal blood vessels can bleed into the vitreous. [4] Retinal tear accounts for 11.4–44% of vitreous hemorrhage cases. [1]
Peripheral (posterior) vitreous detachment occurs when the gel around the eye separates from the retina. This can naturally occur with age. However, if it occurs too rapidly, it can cause photopsia which manifests in flashes and floaters in the vision. Typically, the flashes and floaters go away in a few months.
Laser photocoagulation, or photocoagulation therapy, is the use of a laser to seal a retinal tear. [21] Pneumatic retinopexy; Retinal cryopexy, or retinal cryotherapy, is a procedure that uses intense cold to induce a chorioretinal scar and to destroy retinal or choroidal tissue. [24] Macular hole repair; Partial lamellar sclerouvectomy [25]
Proliferative vitreoretinopathy (PVR) is a disease that develops as a complication of rhegmatogenous retinal detachment.PVR occurs in about 8–10% of patients undergoing primary retinal detachment surgery and prevents the successful surgical repair of rhegmatogenous retinal detachment.
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