A review of rhegmatogenous retinal detachment: past, present and future

Abstract

Retinal detachments are ophthalmic emergencies given their potential to become a permanently blinding disorder if left untreated. This review will outline the history, pathogenesis, clinical presentation, and current and future management of retinal detachments.

Keywords: History; Management; Pathogenesis; Pneumatic retinopexy; Vitrectomy.

Fig. 1

Posterior vitreous detachment generating traction, resulting in a retinal break and retinal detachment [11]

Fig. 2

Summary of the Lincoff rules (blue = retinal detachment area and red = retinal break) a Superior temporal or nasal rhegmatogenous retinal detachment (RRD)—the primary break lies within 1.5 clock hours of the highest border; b total or superior RRD that crosses the 12 o’clock meridian—the primary break occurs at 12 o’clock or within 1.5 clock hours; c inferior RRD—the higher side of the detachment contains the break; d inferior bullous RRD—the primary break is usually a small hole close to 12 o’clock [11]

Fig. 3

Colour fundus photograph of the right eye demonstrating proliferative vitreoretinopathy grade C retinal detachment with retinal star folds

Fig. 4

Inferior macula-sparing retinal detachment in a high myope with lattice degeneration and retinal breaks, barricaded by retinal laser

Fig. 5

Right eye superonasal macula on retinal detachment

Fig. 6

Flattened retina with superior laser over retinal break following pneumatic retinopexy (superior gas bubble visible)

Fig. 7

Inferior and temporal retinal detachment of the right eye, macula is on

Fig. 8

Reattached retina after scleral buckle surgery with cryotherapy

Fig. 9

Left eye inferior retinal detachment involving the macula

Fig. 10

Optical coherence tomography image demonstrating macula involvement in the retinal detachment in Fig. 9

Fig. 11

Post-vitrectomy surgery reattachment of the retina with 360-degree barrier laser

Fig. 12

Optical coherence tomography image demonstrating reattachment of the macula after vitrectomy surgery

Fig. 13

Right eye bullous temporal retinal detachment involving the macula

Fig. 14

Right eye reattached retina after combined scleral buckle and vitrectomy with encircling buckle indentation, 360-degree barrier laser and silicone oil fill for travel