aetiology

Last reviewed 01/2018

Retinal detachment can be divided according to the aetiology into:

Rhegmatogenous or primary - most common cause (1), associated with a break in the neuro-retina or chronic retinal atrophy which results in liquefied vitreous entering the subretinal space leading to detachment (1)Most frequently due to:

  • trauma
  • posterior vitreous detachment

Non-rhegmatogenous or secondary - sensory retina remains intact. Causes include:

  • exudative: accumulation of fluid in the subretinal space from damage to the retinal pigment epithelial layer by
    • hydrostatic factors e.g. severe acute hypertension (2)
    • intra-ocular inflammation eg. posterior uveitis
    • intra-ocular tumours eg. choroidal malignant melanoma, retinoblastoma, choroid haemangioma (Sturge Weber)
  • tractional - contraction of the membranes at the vitreo - retinal junction:
    • most commonly proliferative diabetic retinopathy; also, sickle cell disease, retrolental fibroplasia, toxaemia of pregnancy (hypertension)
    • penetrating eye injury
    • anomalous vitreo-retinal adhesions - Marfan's syndrome

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