R.D. BY: MARWAN ABOUAMMOH

R.D. Rhegmatogenous Tractional Exudative 1/10000 In aphakics: 1-3% Rhegmatogenous R.D. has 5% chance of forming PVR

R.R.D. Vitreous liquifaction R. break Eye’s movement PVD, V-R traction  PVD  Loss of hyaluronic acid  15% of acute PVD have a retinal tear  13-19% have vit. He  PVD+hge= 70% with tears  PVD+no hge= 2-4% with tears  Weiss ring

Acute PVD: Examine preiphery Vit hge = rest, patching ou, examine later U/S

R.D. R ISK FACTORS 1. Lattice & other peripheral degen.: 1. 8% of pop. 2. A cause of RD in 20-30% 3. In RD with L.D.: % atrophic holes % tear at the edge of L.D. 1. Dentate process, oral bay, pars plana island peripheral, cystoid degen., Paving stone degen.,

2. High myopia: >6D 3. Cataract surgery: More with PVD, ICCE>ECCE, Increased risk with P.C.otomy (1.3%), and vit. Loss 50% of R.D.’s in 1 st yr.

4. Glaucoma  > In pigment dispersion syndrome  COAG > in R.D. patients(7% vs. 1%)  Miotics & R.D. 5. R.D. in the fellow eye or FHx of R.D. 6. Trauma: retinal dialysis, giant tear

Symptoms: Exam: don’t forget indentation 40-50% of all R.R.D. have > 1 break usually located 90 degrees from primary break. Types of breaks: Horse-shoe tear Operculated hole Atrophic hole Dialysis

RRDERDTRD VITREOUSPIGMENT ± BLOOD NO PIGMENT ± INFLAMMATO RY CELLS NO PIGMENT FLUIDFAIRLY STATIC DEPENDENT SHIFTING FLUID LITTLE FLUID, NON SHIFTING SHAPECONVEX CORRUGATE D CONVEX SMOOTH CONCAVE RETINAL FEATURES BREAKS ± DEGENERATI ON NORMAL OR FEATURES OF UNDERLYING DISEASE PRERETINAL FIBROSIS

CHRONIC R.D. Retinal thinning Demarcation line Intraretinal cysts PVR

CAUSES OF TRD PRD ROP SCR VMT INCONTINENTIA PIGMENTI RETINAL DYSPLASIA

PVR A B C 1-12 TYPE

ERD: Idiopathic Coats disease Central serous chorioretinopathy Uveal effusion syndrome Inflammatory Vogt-Koyanagi-Harada syndrome Syphilis Scleritis Sympathetic ophthalmia Other vasculitic entities (eg, rheumatoid arthritis, Wegener granulomatosis) Other uveitic conditions (eg, toxoplasmosis, cytomegalovirus [CMV] retinitis) Dengue fever Orbital pseudotumor Lymphomatoid granulomatosis Congenital Nanophthalmos Colobomas of the optic nerve Familial exudative vitreoretinopathy Neoplastic Choroidal melanoma Choroidal metastases Choroidal nevus Choroidal hemangioma Retinoblastoma Primary intraocular lymphoma Iatrogenic Excessive panphotocoagulation Scleral buckling Vascular factors Eclampsia Exudative age-related macular degeneration Chronic renal failure Hypertension