Retinal Detachments Flashcards
(32 cards)
What is a rhegmatogenous RD?
Caused by fluid (liquefied vitreous humour) build-up due to a retinal break.
What is a tractional RD?
Detachment due to pulling on the retina, usually from fibrous membranes, no break.
What is an exudative/serous RD?
Caused by subretinal fluid with no break when RPE is unable to pump fluid leak out quickly enough
What is a PVD?
Posterior vitreous attachments detach, traction can can peripheral vertical flashes (stimulating PRs)
When would VA be affected during an RD?
If macula was off
What are the symptoms of an RD?
None
Flashes
Floaters
Distortion
Curtain field defect
Reduced vision
What are the ocular risk factors for RD?
Myopia
Previous ocular surgery
Laser treatment
Trauma
What are the medical risk factors for RD?
Connective tissue syndromes
Diabetes
Sickle cell retinopathy
When would an RAPD be present in RD?
If it is extensive
What are the signs of an RD?
Tobacco dust
Vitreous haem
PVD
Poss AC activity
What are the signs of chronic RD?
Retinal thinning
Demarcation lines
Intraretinal cysts
Proliferative vitreoretinopathy (fibrous membranes)
When would a B-scan ultrasound be used to investigate an RD?
To check if macula on or off in those with opacities
What are the treatments for retinal tears and holes?
Laser retinopexy
Cryotherapy
What is the aim of retinal hole/tear treatment?
Create barrier so no further detachment can occur (creates chorioretinal scar around it and attaches detached sensory retina to the RPE)
What are the treatments for RD?
Vitrectomy
Scleral buckle
What does the success of RD surgery depend on?
If macula was on or off
How long retina was detached for
Any underlying aetiology
What is the surgical procedure for a vitrectomy?
Clear vitreous
Clear subretinal fluid
Flatten retina
Use laser to create barrier around detachment
Fill with gas or oil as a tamponade
How quickly does the gas bubble wear off?
2-8 weeks
Why would oil be chosen over gas?
Chronic detachment
Complex case
What are the potential complications of RD surgery?
Redetachment
Poor VA (CMO, PR damage)
Increased IOP - Secondary Glaucoma
Refractive changes
Cataract formation
Ocular motility problems/diplopia if scleral buckle
What is a simple PVD?
No break involved
What is a complicated PVD?
Break, detachment or haem present
What are the signs of a PVD?
Crumpled translucent membrane (mid vitreous)
Weiss ring
Vitreous haem
Vitreous cells
Retinal breaks
Shafer’s sign (tobacco dust)
What should you do if you review a PVD with no suspicious features?
Give SOS advice
