What is the pathogenesis of retinal detachment?

Updated: Jul 08, 2021
  • Author: Hemang K Pandya, MD, FACS; Chief Editor: Bruce M Lo, MD, MBA, CPE, RDMS, FACEP, FAAEM, FACHE  more...
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Answer

Retinal detachment refers to separation of the inner layers of the retina from the underlying retinal pigment epithelium (RPE, choroid). The choroid is a vascular membrane containing large branched pigment cells sandwiched between the retina and sclera. Separation of the sensory retina from the underlying RPE occurs by the following 3 basic mechanisms:

  • A hole, tear, or break in the neuronal layer allowing fluid from the vitreous cavity to seep in between and separate sensory and RPE layers (ie, rhegmatogenous retinal detachment)

  • Traction from inflammatory or vascular fibrous membranes on the surface of the retina, which tether to the vitreous

  • Exudation of material into the subretinal space from retinal vessels such as in hypertension, central retinal venous occlusion, vasculitis, or papilledema


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