Chapter 3: Vitreoretinal interface abnormalities

• Lattice degeneration is considered the most important peripheral retinal degeneration process that predisposes to a rhegmatogenous retinal detachment. (See image 1)
• Normally, the retinal pigment epithelium is able to maintain adhesion with the overlying neurosensory retina through a variety of mechanisms: active transport of subretinal fluid and inter-digitation of outer segments and the retinal pigment epithelium microvilli.
• Retinal detachment occurs when subretinal fluid accumulates between the neurosensory retina and the retinal pigment epithelium. This process can occur in three ways:
  • a break in the retina allowing vitreous to directly enter the subretinal space. This is called a rhegmatogenous retinal detachment (often due to retinal tears associated with posterior vitreous detachment or trauma). (See image 2)
  • proliferative membranes on the surface of the retina or vitreous -membranes can pull on the neurosensory retina causing physical separation between the neurosensory retina and retinal pigment epithelium. This is called a traction retinal detachment.
  • accumulation of subretinal fluid due to inflammatory mediators or exudation of fluid from a mass lesion. This is known as a serous or exudative retinal detachment.

Video: Retinal tears & detachments | RCA – Retinal Consultants of Arizona

The referral advice in the atlas should be used as a general guideline. The Optometry Atlas does not establish a standard of optometric care and specific outcomes are not guaranteed. Please read the full details here.