Aetiology

Retinal detachment can be divided according to the aetiology into:

Rhegmatogenous or primary - most common cause (1), associated with a break in the neuro-retina or chronic retinal atrophy which results in liquefied vitreous entering the subretinal space leading to detachment (1)Most frequently due to:

• trauma
• posterior vitreous detachment

Non-rhegmatogenous or secondary - sensory retina remains intact. Causes include:

• exudative: accumulation of fluid in the subretinal space from damage to the retinal pigment epithelial layer by
  • hydrostatic factors e.g. severe acute hypertension (2)
  • intra-ocular inflammation eg. posterior uveitis
  • intra-ocular tumours eg. choroidal malignant melanoma, retinoblastoma, choroid haemangioma (Sturge Weber)
• tractional - contraction of the membranes at the vitreo - retinal junction:
  • most commonly proliferative diabetic retinopathy; also, sickle cell disease, retrolental fibroplasia, toxaemia of pregnancy (hypertension)
  • penetrating eye injury
  • anomalous vitreo-retinal adhesions - Marfan's syndrome

Reference:

• (1) Harding E. sudden visual loss. InnovAiT 2008 1(10):699-705
• (2) Gariano RF, Kim CH. Evaluation and management of suspected retinal detachment. Am Fam Physician. 2004;69(7):1691-8