Retinal detachment

The retina is the innermost layer of tissue of the posterior portion of the eye. It is composed of multiple cellular layers. The outermost layer abuts the vitreal cavity and the innermost layer, the choroid. Retinal detachment is when the neurosensory retina loses adherence to the underlying retinal pigment epithelium (RPE). The outer portion of the neurosensory retina is where the photoreceptors lie. The choroid supplies the oxygen and nutrition for the photoreceptors. Within the fovea, there are no retinal blood vessels, and retinal tissue within this area depends entirely on the choroid for its oxygen requirements. A detachment of the macula can lead to permanent damage to the photoreceptors in this location. Vision is potentially retainable if the macula remains attached, and the retina gets appropriately reattached. However, if the macula comes off, vision may remain poor despite surgical intervention. There are three categories of retinal detachment: rhegmatogenous, tractional, and exudative. Rhegmatogenous retinal detachments are the most common and are caused by fluid passing from the vitreous cavity via a retinal tear or break into the potential space between the sensory retina and the RPE. Tractional detachments occur when proliferative membranes contract and elevate the retina. Components of rhegmatogenous and tractional etiologies may also lead to retinal detachment. Exudative detachments result from fluid accumulation beneath the sensory retina caused by retinal or choroidal diseases