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Retinal Detachment

Retinal Detachment is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • 3 types of retinal detachments with common final pathway:
    • Rhegmatogenous retinal detachments (RRD)
    • Tractional retinal detachments (TRD)
    • Exudative retinal detachments (ERD)
  • RRD:
    • Most common
    • Break or tear of sensory retina allows vitreous fluid to separate the sensory and pigmented parts of retina from each other.
    • Acute event, flashes secondary to tearing of nerve fibers, floaters secondary to bleeding
  • TRD:
    • Contraction of fibrous vitreous bands, as a result of previous insult, pulls the sensory retina off the pigmented retina.
    • Chronic and progressive
    • Asymptomatic unless hemorrhage or retinal tear occurs
  • ERD:
    • Subretinal fluid accumulates and separate retinal layers without violating either layer.
    • Do not usually require surgery
    • Usually secondary systemic disease such as severe acute hypertension, sarcoid, cancer

Etiology

  • RRD:
    • Myopia
    • Cataract surgery
    • Marfan syndrome
    • Structural degeneration of underlying anatomy of vitreous body, sensory or pigmented retina
    • Trauma
  • TRD:
    • Proliferative diabetic retinopathy
    • Vasculopathy
    • Perforating injury
    • Chorioretinitis:
      • Retinopathy of prematurity, sickle cell disease, or toxocariasis
    • Trauma
  • ERD:
    • Malignant hypertension, preeclampsia
    • Tumors of the choroid or retina (melanoma, retinoblastoma)
    • Inflammatory disorders (Coats or Harada disease, posterior scleritis)

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Citation

Rosen, Peter, et al., editors. "Retinal Detachment." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307482/all/Retinal_Detachment.
Retinal Detachment. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307482/all/Retinal_Detachment. Accessed April 23, 2019.
Retinal Detachment. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307482/all/Retinal_Detachment
Retinal Detachment [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 23]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307482/all/Retinal_Detachment.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Retinal Detachment ID - 307482 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307482/all/Retinal_Detachment PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -