Non-rhegmatogenous (Exudative) Retinal Detachment

By posted on July 15, 2014 10:13PM
Non-rhegmatogenous (Exudative) Retinal Detachment

Non-rhegmatogenous (Exudative) Retinal Detachment 

Key Facts 
• Elevation of retina from accumulation of fluid, exudate, or blood in the subretinal space in the absence of retinal break or traction
• The pathophysiology includes: • breakdown of the blood–retinal barrier (e.g. central serous retinopathy, Harada disease) • an increase in fluid flow into the subretinal space (e.g. choroidal tumors, malignant hypertension) and/or impairment in outflow of fluid from the eye (e.g. scleritis) combined with inability of the retinal pigment epithelium to pump fluid out of the subretinal space
Clinical Findings
• Smooth and convex elevation of the retina
• Detachment may be limited and localized to the macula or may be bullous and extend to the ora serrata
• When bullous, fluid tends to shift on changes in head positioning
• Absence of a retinal tear
• Fluid in subretinal space may be proteinaceous, serous (clear or turbid), or hemorrhagic
• Ocular signs such as redness or pain vary depending on underlying etiology
Ancillary Testing 
• Fluorescein angiography to show focal areas of choroidal or retinal leakage
• Ultrasound to image: • the subretinal space for presence of tumors • a thickened choroid in inflammatory disorders • the retina when vitreous hemorrhage present
• Optical coherence tomography to evaluate and follow shallow neurosensory detachments
• CT or MRI when orbital pathology suspected
• Hematologic evaluation of systemic inflammatory disorders
Differential Diagnosis
• Rhegmatogenous retinal detachment
• Retinoschisis
• Choroidal effusion
• Suprachoroidal hemorrhage
• Choroidal tumor
Treatment 
• Treat any underlying systemic or ocular condition

Prognosis 

• Visual outcome depends on underlying cause of exudative retinal detachment

Non-rhegmatogenous (Exudative) Retinal Detachment
Non-rhegmatogenous (Exudative) Retinal Detachment

Source: 

Ophthalmology Atlas(Photos of cases)

Non-rhegmatogenous (Exudative) Retinal Detachment

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