Retinal Detachment RD, st. John Eye Hospital, Moh. Al-Khaldi, 2014

RETINAL DETACHMENT

Mohammed Al-KhaldiMPH

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RD related Epidemiological facts

• The incidence of RD in otherwise normal eyes is around 5 new cases in 100,000 persons per year.

• RD is more frequent in middle-aged or elderly, with rates of around 20 in 100,000 per year, and the lifetime risk in normal individuals is about 1 in 300.

• RD is more common in people with severe myopia (above 5–6 diopters), in whom the retina is more thinly stretched. In such patients, lifetime risk rises to 1 in 20.

• About two-thirds of cases of RD occur in myopics. Myopic retinal detachment patients tend to be younger than non-myopic ones.

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Contd,

RD related Epidemiological facts• RD is more frequent after surgery for cataracts. The estimated

long-term prevalence of RD after cataract surgery is in the range of 5 to 16 per 1000 cataract operations, but is much higher in patients who are highly myopic, with a prevalence of up to 7% being reported in one study.

• A study found that the probability of experiencing retinal detachment within 10 years of cataract surgery may be about 5 times higher than in the absence of treatment.

• Although RD usually occurs in just one eye, there is a 15% chance of it developing in the other eye, and this risk increases to 25–30% in patients who have had a retinal detachment and cataracts extracted from both eyes.

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RETINA• light-sensitive layer

of tissue • sends visual

messages through the optic nerve

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• pulled away from the underlying choroid

• small areas of the retina torn =>

retinal tears or retinal breaks

• retinal cells deprived of oxygen

• if not promptly treated => permanent vision loss

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SYMPTOMS• floaters - bits of debris in field of vision that

look like spots, hairs or strings

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SYMPTOMS• floaters• light flashes• shadow or curtain over a

portion of visual field • blur in vision

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Can occur as a result of:

• trauma • advanced diabetes • an inflammatory disorder, such as

sarcoidosis• shrinkage of the jelly-like vitreous that fills

the inside of the eye

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• vitreous liquid leaks through retinal tear and accumulates underneath retina

• retina can peel away from underlying layer of blood vessels

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Factors that may increase risk of retinal detachment

• aging - more common in people older than 40 • previous retinal detachment in one eye • family history of retinal detachment • extreme nearsightedness • previous eye surgery• previous severe eye injury or trauma

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TREATMENTSRetinal tears:• laser surgery (photocoagulation)• freezing (cryopexy)Retinal detachment:• pneumatic retinopexy• scleral buckling• vitrectomy

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PHOTOCOAGULATION

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CRYOPEXY

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PNEUMATIC RETINOPEXY

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PNEUMATIC RETINOPEXY

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SCLERAL BUCKLING

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VITRECTOMY

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When a surgeon injects a bubble of expandable gas into the vitreous cavity it is called:

• scleral buckling• vitrectomy• pneumatic retinopexy• photocoagulation• cryopexy

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Important hint related to the results of surgery

85 % of the cases dealt with successfully in a single operation with 15 % of the remaining cases need to be two or more. After treatment, patients regain their vision therapists gradually over a period of a few weeks, despite the fact that visual acuity may not be as good as it was before the detachment, especially if the spot included in the detachment.

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Retinal detachment can occur as a result of;•Obesity•Trauma•Nearsightedness

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When a surgeon uses intense cold to freeze the retina around the retinal tear it is called;

• Scleral buckling• Vitrectomy• Pneumatic retinopexy• Photocoagulation• Cryopexy

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