Rhegmatogenous retinal detachment--an ophthalmologic emergency

Dtsch Arztebl Int. 2014 Jan 6;111(1-2):12-21; quiz 22. doi: 10.3238/arztebl.2014.0012.

Abstract

Background: Rhegmatogenous retinal detachment is the most common retinological emergency threatening vision, with an incidence of 1 in 10 000 persons per year, corresponding to about 8000 new cases in Germany annually. Without treatment, blindness in the affected eye may result.

Method: Selective review of the literature.

Results: Rhegmatogenous retinal detachment typically presents with the perception of light flashes, floaters, or a "dark curtain." In most cases, the retinal tear is a consequence of degeneration of the vitreous body. Epidemiologic studies have identified myopia and prior cataract surgery as the main risk factors. Persons in the sixth and seventh decades of life are most commonly affected. Rhegmatogenous retinal detachment is an emergency, and all patients should be seen by an ophthalmologist on the same day that symptoms arise. The treatment consists of scleral buckle, removal of the vitreous body (vitrectomy), or a combination of the two. Anatomical success rates are in the range of 85% to 90%. Vitrectomy is followed by lens opacification in more than 70% of cases. The earlier the patient is seen by an ophthalmologist, the greater the chance that the macula is still attached, so that visual acuity can be preserved.

Conclusion: Rhegmatogenous retinal detachment is among the main emergency indications in ophthalmology. In all such cases, an ophthalmologist must be consulted at once.

Publication types

  • Review

MeSH terms

  • Capsule Opacification / etiology*
  • Capsule Opacification / prevention & control
  • Emergency Medical Services / methods*
  • Eye Diseases, Hereditary / complications
  • Eye Diseases, Hereditary / diagnosis*
  • Eye Diseases, Hereditary / surgery*
  • Humans
  • Retinal Detachment / complications
  • Retinal Detachment / diagnosis*
  • Retinal Detachment / surgery*
  • Retinoscopy / methods*
  • Treatment Outcome
  • Vision Disorders / diagnosis
  • Vision Disorders / etiology*
  • Vision Disorders / prevention & control*
  • Vitrectomy / adverse effects*
  • Vitrectomy / methods

Supplementary concepts

  • Rhegmatogenous Retinal Detachment, Autosomal Dominant