Wide spectrum of retinal detachments – an insight into pathogenesis, medical examination and treatment Review article
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Abstract
Retinal detachment is a serious condition requiring prompt treatment to prevent vision loss. This review covers diagnosis, treatment options, and factors influencing clinical decisions. Despite its rarity, untreated detachment often leads to blindness. Early detection and intervention are crucial. Advances in imaging enhance diagnosis accuracy. Treatment ranges from conservative to surgical interventions like pneumoretinopexy, scleral buckling and vitrectomy. The review emphasizes the importance of timely diagnosis and treatment, highlighting the impact of early intervention on disease progression and vision preservation.
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Piłka N, Drabczyk M, Sirek S, Wyględowska-Promieńska D. Wide spectrum of retinal detachments – an insight into pathogenesis, medical examination and treatment. Ophthatherapy [Internet]. 2024Dec.31 [cited 2025Feb.22];11(4). Available from: https://journalsmededu.pl/index.php/ophthatherapy/article/view/3073
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References
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2. Bradbury MJ, Landers MB. Pathogenetic mechanisms of retinal detachment. In: Retina. 3rd ed. Ryan SJ, Wilkinson CP (eds.). Mosby, St Louis 2001: 1987-93.
3. Kang HK, Luff AJ. Management of retinal detachment: a guide for non-ophthalmologists. BMJ. 2008; 336(7655): 1235-4. https://doi.org/10.1136/bmj.39581.525532.47.
4. Byer NE. Changes in prognosis of lattice degeneration of the retina. Tr Am Acad Ophth and Otol. 1974; 78: 114-25.
5. Itakura H, Kishi S. Aging changes of vitreomacular interface. Retina. 2011; 31: 1400-4. https://doi.org/10.1097/IAE.0b013e318206cb43.
6. Los LI, van der Worp RJ, van Luyn MJ et al. Age-related liquefaction of the human vitreous body: LM and TEM evaluation of the role of proteoglycans and collagen. Invest Ophthalmol Vis Sci. 2003; 44: 2828-33. https://doi.org/10.1167/iovs.02-0588.
7. Oliveira LB, Tatebayashi M, Mahmoud TH et al. Dispase facilitates posterior vitreous detachment during vitrectomy in young pigs. Retina. 2001; 21: 342-31. https://doi.org/10.1097/00006982-200108000-00005.
8. Green WR, Sebag J . Vitreoretinal interface In: Retina. Vol. 3. 3rd ed. Ryan SJ, Wilkinson CP (eds.). Mosby, St Louis 2001: 1882-960.
9. Foos RY, Wheeler NC. Vitreretinal juncture. Synchysis senilis and posterior vitreous detachment. Ophthalmology. 1982; 89: 1502-12. https://doi.org/10.1016/s0161-6420(82)34610-2.
10. Hagler WS, Jarrett WH, Chang MC. Rhematogenous retinal detachment following chorioretinal inflammatory disease. Am J Ophthalmol. 1978; 86: 373-9. https://doi.org/10.1016/0002-9394(78)90242-8.
11. Broghton WL, Cupples HP, Parver LM. Bilateral retinal detachment following cytomegalovirus retinitis. Arch Ophthalmol. 1978; 96: 618-9. https://doi.org/ 10.1001/archopht.1978.03910050314003.
12. Duker JS, Blumenkranz MS. Diagnosis and management of the acute retinal necrosis (ARN) syndrome. Surv Ophthalmol. 1991; 35: 327-43. https://doi.org/ 10.1016/0039-6257(91)90183-g .
13. Colucciello M. Rhegmatogenous retinal detachment. Phys Sportsmed. 2009; 37(2): 59-65. https://doi.org/10.3810/psm.2009.06.1710.
14. Mishra C, Tripathy K. Retinal traction detachment. In: StatPearls. StatPearls Publishing, Treasure Island, FL 2021.
15. Blair K, Czyz CN. Retinal Detachment. In: StatPearls. StatPearls Publishing, Treasure Island, FL 2024.
16. Nkanga DG, Agweye CT, Okonkwo ON et al. Collaborative Retina Research Network (CRRN), Study Report 1. Tractional Retinal Detachment: Prevalence and Causes in Nigerians. J West Afr Coll Surg. 2023; 13(4): 58-62. https://doi.org/10.4103/jwas.jwas_40_23.
17. Hajee A, Makgotloe MA. An update on the management of diabetic tractional retinal detachment. Afr Vision Eye Health. 2022; 81(1): a774. https://doi.org/10.4102/aveh.v81i1.774.
18. Stewart MW, Browning DJ, Landers MB. Current management of diabetic tractional retinal detachments. Indian J Ophthalmol. 2018; 66(12): 1751-62. https://doi.org/10.4103/ijo.IJO_1217_18.
19. Simmons-Rear A, Yeh S, Chan-Kai BT et al. Characterization of serous retinal detachments in uveitis patients with optical coherence tomography. J Ophthal Inflamm Infect. 2012; 2: 191-7. https://doi.org/10.1007/s12348-012-0084-8.
20. Marmor MF. New hypothesis on the pathogenesis and treatment of serous retinal detachment. Graefe’s Arch Clin Exp Ophthalmol. 1988; 226: 548-52. https://doi.org/10.1007/BF02169203.
21. Catier A, Tadayoni R, Paques M et al. Characterization of macular edema from various etiologies by optical coherence tomography. Am J Ophthalmol. 2005; 140: 200-6. https://doi.org/10.1016/j.ajo.2005.02.053.
22. Jalali S. Retinal detachment. Community Eye Health. 2003; 16(46): 25-6.
23. Uhr JH, Obeid A, Wibbelsman TD et al. Delayed retinal breaks and detachments after acute posterior vitreous detachment. Ophthalmology. 2020; 127: 516-22. https://doi.org/10.1016/j.ophtha.2019.10.020.
24. Lewis H. Peripheral retinal degenerations and the risk of retinal detachment. Am J Ophthalmol. 2003; 136: 155-60. https://doi.org/10.1016/s0002-9394(03)00144-2.
25. Steel D. Retinal detachment. BMJ Clin Evid. 2014; 2014: 0710.
26. García-Arumí J, Martínez-Castillo V, Boixadera A et al. Rhegmatogenous retinal detachment treatment guidelines. Arch Soc Esp Oftalmol. 2013; 88(1): 11-35. https://doi.org/10.1016/j.oftal.2011.10.013.
27. Risk factors for idiopathic rhegmatogenous retinal detachment. the eye disease case-control study Group. Am J Epidemiol. 1993; 137: 749-57.
28. Sheu SJ, Ger LP, Chen JF. Male sex as a risk factor for pseudophakic retinal detachment after cataract extraction in Taiwanese adults. Ophthalmology. 2007; 114(10): 1898-903. https://doi.org/10.1016/j.ophtha.2007.02.030.
29. Clark A, Morlet N, Ng JQ et al. Risk for Retinal Detachment After Phacoemulsification: A Whole-Population Study of Cataract Surgery Outcomes. Arch Ophthalmol. 2012; 130(7): 882-88. https://doi.org/10.1001/archophthalmol.2012.164.
30. Olsen T, Jeppesen P. The incidence of retinal detachment after cataract surgery. Open Ophthalmol J. 2012; 6: 79-82. https://doi.org/10.2174/1874364101206010079.
31. Kolb H. Facts and Figures Concerning the Human Retina. In: Webvision. The Organization of the Retina and Visual System. Kolb H, Fernandez E, Nelson R (eds.). University of Utah Health Sciences Center, Salt Lake City (UT): May 1, 2005.
32. Shah DN, Al-Moujahed A, Newcomb CW et al. Systemic Immunosuppressive Therapy for Eye Diseases Research Group. Exudative Retinal Detachment in Ocular Inflammatory Diseases: Risk and Predictive Factors. Am J Ophthalmol. 2020; 218: 279-87. https://doi.org/10.1016/j.ajo.2020.06.019.
33. Sultan ZN, Agorogiannis EI, Iannetta D et al. Rhegmatogenous retinal detachment: a review of current practice in diagnosis and management. BMJ Open Ophthalmol. 2020; 5(1): e000474.
34. Gariano RF, Kim CH. Evaluation and management of suspected retinal detachment. Am Fam Physician. 2004; 69(7): 1691-8.
35. Feltgen N, Walter P. Rhegmatogenous retinal detachment – n ophthalmologic emergency. Dtsch Arztebl Int. 2014; 111(1-2): 12-21. https://doi.org/10.3238/arztebl.2014.0012.
36. Lincoff H, Gieser R. Finding the retinal hole. Arch Ophthalmol 1971; 85: 565-9. https://doi.org/10.1001/archopht.1971.0099005056700.
37. Iyer SSR, Regan KA, Burnham JM et al. Surgical management of diabetic tractional retinal detachments. Surv Ophthalmol. 2019; 64(6): 780-809. https://doi.org/10.1016/j.survophthal.2019.04.008.
38. Meredith TA, Kaplan HJ, Aaberg TM. Pars plana vitrectomy techniques for relief of epiretinal traction by membrane segmentation. Am J Ophthalmol. 1980; 89(3): 408. https://doi.org/10.1016/0002-9394(80)90012-4.
39. Abunajma MA, Al-Dhibi H, Abboud EB et al. The outcomes and prognostic factors of vitrectomy in chronic diabetic traction macular detachment. Clin Ophthalmol. 2016; 10: 1653. https://doi.org/10.2147/OPTH.S98555.
40. Shukla UV, Gupta A, Tripathy K. Exudative Retinal Detachment. In: StatPearls. StatPearls Publishing, Treasure Island (FL) 2023.
41. Kirchhof B. The diseased vitreous body: Malformations, developmental disorders and opacities. Ophthalmologe. 2015; 112(7): 559-63. https://doi.org/10.1007/s00347-015-0059-x .
42. Rabinowitz R, Yagev R, Shoham A et al. Comparison between clinical and ultrasound findings in patients with vitreous hemorrhage. Eye (Lond). 2004; 18(3): 253. https://doi.org/10.1038/sj.eye.6700632.
43. Lahham S, Ali Q, Palileo BM et al. Role Of Point Of Care Ultrasound In The Diagnosis Of Retinal Detachment In The Emergency Department. Open Access Emerg Med. 2019; 11: 265-70. https://doi.org/10.2147/OAEM.S219333.
44. Green RL, Bryne SF. Diagnostic ophthalmic ultrasound. In: Retina. 1 ed. Ryan SJ (ed.). Mosby, St Louis 1989: 191.
45. Pierro L, Rabiolo A. Emerging issues for optical coherence tomography. Dev Ophthalmol. 2017; 60: 28. https://doi.org/10.1159/000459723.
46. Ross WH. Visual recovery after macula-off retinal detachment. Eye. 2002; 16(4): 440-46.
47. Imai M, Iijima H, Hanada N. Optical coherence tomography of tractional macular elevations in eyes with proliferative diabetic retinopathy. Am J Ophthalmol. 2001; 132(3): 458. https://doi.org/10.1016/s0002-9394(01)01176-x.
48. de Barros Garcia JMB, Isaac DLC, Avila M. Diabetic retinopathy and OCT angiography: clinical findings and future perspectives. Int J Retina Vitreous. 2017; 3: 14. https://doi.org/10.1186/s40942-017-0062-2.
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