Skip to main content

Treatment of Retinal Detachment

  • Chapter
  • First Online:
Lee's Ophthalmic Histopathology
  • 1604 Accesses

Abstract

This chapter serves primarily as a guide to the causative pathology and the secondary disturbances that are encountered when an enucleated eye is submitted with a clinical history of “Retinal detachment – treatment unsuccessful.” Retinal detachment may be “Rhegmatogenous” which occurs when fluid passes from the vitreous cavity through a hole in the retina into the “subretinal space.” The “hole” or “tear” is most commonly secondary to degenerative disease in the retina and vitreous. By contrast, “exudative” detachment refers to accumulation of fluid under the neural retina in situations in which there is abnormally excessive permeability in the retinal vessels or in the choroidal vessels. This process is encountered in inflammation or neoplasia and in retinal or choroidal vasculopathy with loss of endothelial cell integrity, and in this event the subretinal space is filled with a more viscous proteinaceous exudate. “Traction” detachment occurs when there is condensation or organization of the vitreous, by trauma or neovascularization. In the treatment of retinal detachment there are basically two lines of approach to sealing off a hole in the retina after subretinal fluid has been drained either by indenting the sclera and choroid so that the retinal hole is sealed or by replacing the vitreous with a bubble of silicone oil, or inert gas. The pathological effects at these attempts at treatment are commonly seen in globes enucleated for retinal detachment.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Foos RY, Allen RA. Retinal tears and lesser lesions of the peripheral retina in autopsy eyes. Am J Ophthalmol. 1967;64:643–55.

    PubMed  Google Scholar 

  2. Barr CC. The histopathology of successful retinal reattachment. Retina. 1990;10:189–94.

    PubMed  CAS  Google Scholar 

  3. Chang C-J, Lai WW, Edward DP, Tso MOM. Apoptotic photoreceptor cell death after traumatic retinal detachment in humans. Arch Ophthalmol. 1995;113:880–6.

    Article  PubMed  CAS  Google Scholar 

  4. Luthert PJ, Chong NH. Photoreceptor rescue. Eye. 1998;12:591–6.

    Article  PubMed  Google Scholar 

  5. Nork TM, Millechia LL, Strickland BD, Linberg JV, Chao G-M. Selective loss of blue cones and rods in human retinal detachment. Arch Ophthalmol. 1995;113:1066–73.

    Article  PubMed  CAS  Google Scholar 

  6. Cherfan GM, Smiddy WE, Michels RG, de la Cruz Z, Wilkinson CP, Green WR. Clinicopathologic correlation of pigmented epiretinal membranes. Am J Ophthalmol. 1988;106:536–45.

    Article  PubMed  CAS  Google Scholar 

  7. Hui Y-N, Goodnight R, Zhang X-J, Sorgente N, Ryan S. Glial epiretinal membranes and contraction. Immunohistochemical and morphologic studies. Arch Ophthalmol. 1988;106:1280–5.

    Article  PubMed  CAS  Google Scholar 

  8. Morino I, Hiscott P, McKechnie N, Grierson I. Variation in epiretinal membrane components with clinical duration of the proliferative tissue. Br J Ophthalmol. 1990;74:393–9.

    Article  PubMed  CAS  Google Scholar 

  9. Nork TM, Wallow IH, Sramek SJ, Stevens TS, De Venecia G. Immuno-cytochemical study of an eye with proliferative vitreoretinopathy and retinal tacks. Retina. 1990;10:78–85.

    Article  PubMed  CAS  Google Scholar 

  10. Ohira A, de Juan Jr E. Characterization of glial involvement in proliferative diabetic retinopathy. Ophthalmologica. 1990;201:187–95.

    Article  PubMed  CAS  Google Scholar 

  11. Hiscott P, Gray R, Grierson I, Gregor Z. Cytokeratin-containing cells in proliferative diabetic retinopathy membranes. Br J Ophthalmol. 1994;78:219–22.

    Article  PubMed  CAS  Google Scholar 

  12. Pastor JC. Proliferative vitreoretinopathy: an overview. Surv Ophthalmol. 1998;43:3–18.

    Article  PubMed  CAS  Google Scholar 

  13. Casaroli-Marano RP, Pagan R, Vilaro S. Epithelial-mesenchymal transition in proliferative vitreoretinopathy: intermediate filament protein expression in retinal pigment epithelial cells. Invest Ophthalmol Vis Sci. 1999;40:2062–72.

    PubMed  CAS  Google Scholar 

  14. Boulton M, Foreman D, Williams G, Mcleod D. VEGF localisation in diabetic retinopathy. Br J Ophthalmol. 1998;82:561–8.

    Article  PubMed  CAS  Google Scholar 

  15. Toti P, Greco G, Montolese E, Stumpo M, Cardone C, Tosi GM. Cell composition and immunohistochemical detection of VEGF, TGF-beta and TNF-alpha in proliferative vitreoretinopathy. J Submicrosc Cytol Pathol. 1999;31:363–6.

    PubMed  CAS  Google Scholar 

  16. Ahlers C, Geitzenauer W, Stock G, Golbaz I, Schimdt-Erfurth U, Prunte C. Alterations of intraretinal layers in acute central serous chorioretinopathy. Acta Ophthalmol. 2009;87:511–6.

    Article  PubMed  Google Scholar 

  17. Mazzuca DE, Benson WE. Central serous retinopathy: variants. Surv Ophthalmol. 1986;31:170–4.

    Article  PubMed  CAS  Google Scholar 

  18. Smiddy WE, Michels RG, Green WR. Morphology, pathology, and surgery of idiopathic vitreoretinal macular disorders. Retina. 1990;10:288–96.

    PubMed  CAS  Google Scholar 

  19. Bouzas EA, Karadimas P, Pournaras CJ. Central serous chorioretinopathy. Surv Ophthalmol. 2002;47:431–48.

    Article  PubMed  Google Scholar 

  20. Straatsma BR, Zeegen PD, Foos RY, Feman SS, Shabo AL. Lattice degeneration of the retina. Am J Ophthalmol. 1974;77:619–49.

    PubMed  CAS  Google Scholar 

  21. Byer NE. Long-term natural history of lattice degeneration of the retina. Ophthalmology. 1989;96:1396–401.

    Article  PubMed  CAS  Google Scholar 

  22. Krohn J, Seland JH. Simultaneous bilateral rhegmatogenous retinal detachment. Acta Ophthalmol Scand. 2000;78:354–8.

    Article  PubMed  CAS  Google Scholar 

  23. Rosa RH, Glaser BM, de la Cruz Z, Green WR. Clinicopathologic correlation of an untreated macular hole and a macular hole treated by vitrectomy, transforming growth factor-ß2, and gas tamponade. Am J Ophthalmol. 1996;122:853–63.

    PubMed  Google Scholar 

  24. Schadlu R, Tehrani S, Shah GK, Prasad AG. Long-term follow-up results of ilm peeling during vitrectomy surgery for premacular fibrosis. Retina. 2008;28:853–7.

    Article  PubMed  Google Scholar 

  25. Bainbridge J, Herbert E, Gregor Z. Macular holes: vitreoretinal relationships and surgical approaches. Eye. 2008;22:1301–9.

    Article  PubMed  CAS  Google Scholar 

  26. Gass JDM. Idiopathic senile macular hole. Its early stages and pathogenesis. Arch Ophthalmol. 1988;106:629–39.

    Article  PubMed  CAS  Google Scholar 

  27. Akiba J, Quiroz MA, Trempe CL. Role of posterior vitreous detachment in idiopathic macular holes. Ophthalmology. 1990;97:1610–3.

    Article  PubMed  CAS  Google Scholar 

  28. Ezra E, Munro PM, Charteris DG, Aylward WG, Luthert PJ, Gregor ZJ. Macular hole opercula. Ultrastructural features and clinicopathological correlation. Arch Ophthalmol. 1997;115:1381–7.

    Article  PubMed  CAS  Google Scholar 

  29. O’Malley PF, Allen RA. Peripheral cystoid degeneration of the retina: incidence and distribution in 1,000 autopsy cases. Arch Ophthalmol. 1967;77:769–76.

    Article  PubMed  Google Scholar 

  30. Smiddy WE, Michels RG, Gilbert HD, Green WR. Clinicopathologic study of idiopathic macular pucker in children and young adults. Retina. 1992;12:232–6.

    Article  PubMed  CAS  Google Scholar 

  31. Messmer EM, Heidenkummer HP, Kampik A. Ultrastructure of epiretinal membranes associated with macular holes. Graefes Arch Clin Exp Ophthalmol. 1998;236:248–54.

    Article  PubMed  CAS  Google Scholar 

  32. Ishida S, Yamakazi K, Shinoda K, Kawashima S, Oguchi Y. Macular hole retinal detachment in highly myopic eyes: ultrastructure of epiretinal membrane and clinicopathological correlation. Retina. 2000;20:176–83.

    Article  PubMed  CAS  Google Scholar 

  33. Toomes C, Bottomley HM, Scott S, Mackey DA, Craig JE, Appukuttan B, et al. Spectrum and frequency of FZD4 mutations in familial exudative vitreoretinopathy. Invest Ophthalmol Vis Sci. 2004;45:2083–90.

    Article  PubMed  Google Scholar 

  34. Warden SM, Andreoli CM, Mukai S. The Wnt signalling pathway in familial exudative vitreoretinopathy and Norrie disease. Semin Ophthalmol. 2007;22:211–7.

    Article  PubMed  Google Scholar 

  35. Boldrey EE, Egbert P, Gass JDM, Friberg T. The histopathology of familial exudative vitreoretinopathy. Arch Ophthalmol. 1985;103:238–41.

    Article  PubMed  CAS  Google Scholar 

  36. Glazer LC, Maguire A, Blumenkranz MS, Trese MT, Green WR. Improved surgical treatment of familial exudative vitreoretinopathy. Am J Ophthalmol. 1995;120:471–9.

    PubMed  CAS  Google Scholar 

  37. Goodwin P. Hereditary retinal disease. Curr Opin Ophthalmol. 2008;19:255–62.

    Article  PubMed  Google Scholar 

  38. Mooy CM, Baarsma S, Paridaens DA, Bergen A, Weber BHF. Hereditary X-linked juvenile retinoschisis: a review of the role of Muller cells. Arch Ophthalmol. 2002;120:979–84.

    PubMed  Google Scholar 

  39. MacRae ME, Patel DV, Richards AJ, Snead MP, Tomie J, Lee WR. Type 1 Stickler syndrome: a histological and ultrastructural study of an untreated globe. Eye. 2006;20:1061–7.

    Article  PubMed  CAS  Google Scholar 

  40. O’Malley PF, Allen RA, Straatsma BR, O’Malley CC. Paving stone degeneration of the retina. Arch Ophthalmol. 1965;73:169–82.

    Article  PubMed  Google Scholar 

  41. Daicker B. The macular fatty degeneration of the peripheral retina. Albrecht Von Graefes Arch Ophthalmol. 1978;205:147–55.

    CAS  Google Scholar 

  42. Meyer E, Kurz GH. Retinal pits: a study of pathological findings in two cases. Arch Ophthalmol. 1963;70:640–6.

    Article  PubMed  CAS  Google Scholar 

  43. To KW, Adamian M, Jakobiec FA, Berson EL. Clinical and histopathologic findings in clumped pigmentary retinal degeneration. Arch Ophthalmol. 1996;114:950–5.

    Article  PubMed  CAS  Google Scholar 

  44. Schorderet DF, Escher P. NR2E3 mutations in enhanced S-cone sensitive syndrome (ESCS), Goldmann-Favre syndrome (GFS), clumped pigmentary retinal degeneration (CPRD), and retinitis pigmentosa (RP). Hum Mutat. 2009;30:1475–85.

    Article  PubMed  CAS  Google Scholar 

  45. Foos RY, Freeman SS. Reticular cystoid degeneration of the peripheral retina. Am J Ophthalmol. 1970;69:392–403.

    PubMed  CAS  Google Scholar 

  46. Straatsma BR, Foos RY. Typical and reticular degenerative retinoschisis. Am J Ophthalmol. 1973;75:551–75.

    PubMed  CAS  Google Scholar 

  47. Hornbeak DM, Young TL. Myopia genetics: a review of current research and emerging trends. Curr Opin Ophthalmol. 2009;20:356–62.

    Article  PubMed  Google Scholar 

  48. Wickham L, Sethi CS, Lewis GP, Fisher SK, McLEod DC, Charteris DG. Glial and neural response in short-term human retinal detachment. Arch Ophthalmol. 2006;124:1779–81.

    Article  PubMed  Google Scholar 

  49. Lewis GP, Fisher SK. Müller cell outgrowth after retinal detachment: association with cone photoreceptors. Invest Ophthalmol Vis Sci. 2000;41:1542–5.

    PubMed  CAS  Google Scholar 

  50. Fisher SK, Lewis GP, Linberg KA, Verardo MR. Cellular remodelling in mammalian retina: results from studies of experimental retinal detachment. Prog Retin Eye Res. 2005;24:395–431.

    Article  PubMed  Google Scholar 

  51. Monshizadeh R, Samiy N, Haimovici R. Management of retained intravitreal lens fragments after cataract surgery. Surv Ophthalmol. 1999;43:397–404.

    Article  PubMed  CAS  Google Scholar 

  52. D’hermies F, Korobelnik JF, Chauvaud D, Pouliquen Y, Parel JM, Renard G. Scleral and episcleral histological changes related to encircling explants in 20 eyes. Acta Ophthalmol Scand. 1999;77:279–85.

    Article  PubMed  Google Scholar 

  53. O’Donoghue E, Lightman S, Tuft S, Watson P. Surgically induced necrotising sclerokeratitis (SINS)-precipitating factors and response to treatment. Br J Ophthalmol. 1992;76:17–21.

    Article  PubMed  Google Scholar 

  54. Nakamura K, Refojo MF, Crabtree DV, Leong FL. Analysis and fractionation of silicone oil and fluorosilicone oils for intraocular use. Invest Ophthalmol Vis Sci. 1990;31:2059–69.

    PubMed  CAS  Google Scholar 

  55. Yang CS, Chen KH, Hsu WM, Li YS. Cytotoxicity of silicone oil on cultivated human corneal endothelium. Eye. 2008;22:282–8.

    Article  PubMed  CAS  Google Scholar 

  56. Foulks GN, Hatchell DL, Proia AD, Klintworth GK. Histopathology of silicone oil keratopathy in humans. Cornea. 1991;10:29–37.

    PubMed  CAS  Google Scholar 

  57. Azuara-Blanco A, Dua HS, Pillai CT. Pseudoendothelial dystrophy associated with emulsified silicon oil. Cornea. 1999;18:493–4.

    Article  PubMed  CAS  Google Scholar 

  58. Eckardt C, Nicolai U, Czank M, Schmidt D. Identification of silicone oil in the retina after intravitreal injection. Retina. 1992;12:S17–22.

    Article  PubMed  CAS  Google Scholar 

  59. Eller AW, Friberg TR, Mah F. Migration of silicone oil into the brain: a complication of intraocular silicone oil for retinal tamponade. Am J Ophthalmol. 2000;129:685–8.

    Article  PubMed  CAS  Google Scholar 

  60. Heimann H, Stappler T, Wong D. Heavy tamponade 1: a review of indications, use and complications. Eye. 2008;22:1342–59.

    Article  PubMed  CAS  Google Scholar 

  61. Hiscott P, Magee RM, Colthurs M, Lois N, Wong D. Clinicopathological correlation of epiretinal membranes and posterior lens opacification following perfluorohexyloctane tamponade. Br J Ophthalmol. 2001;85:179–83.

    Article  PubMed  CAS  Google Scholar 

  62. Kirchhof B. Strategies to influence PVR development. Graefes Arch Clin Exp Ophthalmol. 2004;242:699–703.

    Article  PubMed  CAS  Google Scholar 

  63. Federman JL, Eagle RC. Extensive peripheral retinectomy combined with posterior 360 degrees retinopathy for retinal reattachment in advanced proliferative vitreoretinopathy cases. Ophthalmology. 1990;97:1305–20.

    Article  PubMed  CAS  Google Scholar 

  64. Wong D, Lois N. Foveal relocation by redistribution of the neurosensory retina. Br J Ophthalmol. 2000;84:352–7.

    Article  PubMed  CAS  Google Scholar 

  65. Eandi CM, Giansanti F, Virgili G (2008) Macular translocation for neovascular age-related macular degeneration. Cochrane Database Syst Rev (4):CD006928

    Google Scholar 

  66. Hiscott P, Wong D, Grierson I. Challenges in ophthalmic pathology: the vitreoretinal membrane biopsy. Eye. 2000;14:549–59.

    Article  PubMed  Google Scholar 

  67. Snead DRJ, James S, Snead MP. Pathological changes in the vitreoretinal junction 1: epiretinal membrane formation. Eye. 2008;22:1310–7.

    Article  PubMed  CAS  Google Scholar 

  68. Harada C, Mitamura Y, Takayuki H. The role of cytokines and trophic factors in epiretinal membranes: involvement of signal transduction in glial cells. Prog Retin Eye Res. 2006;25:149–64.

    Article  PubMed  CAS  Google Scholar 

  69. Coupland SE. The pathologist’s perspective on vitreous opacities. Eye. 2008;22:1318–29.

    Article  PubMed  CAS  Google Scholar 

  70. Scott JA, Damato BE, Smith PA, Gurney PWV. Scleral explant mimicking malignant melanoma. Eye. 1994;8:606–8.

    Article  PubMed  Google Scholar 

  71. Kador PR, Wyman M. Asteroid hyalosis: pathogenesis and prospects for prevention. Eye. 2008;22:1278–85.

    Article  PubMed  CAS  Google Scholar 

  72. Winckler J, Lundsdorf H. Ultrastructure and composition of asteroid bodies. Invest Ophthalmol Vis Sci. 2001;42:902–7.

    Google Scholar 

  73. Komatsu H, Kamura Y, Ishi K, Kashima Y. Fine structure and morphogenesis of asteroid hyalosis. Med Electron Microsc. 2003;36:112–9.

    PubMed  Google Scholar 

  74. Sehu KW, Lee WR, editors. Ophthalmic pathology: an illustrated guide for clinicians. Malden: Blackwell Publishing Ltd; 2008. ISBN 9780727917799.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag London

About this chapter

Cite this chapter

Roberts, F., Thum, C.K. (2014). Treatment of Retinal Detachment. In: Lee's Ophthalmic Histopathology. Springer, London. https://doi.org/10.1007/978-1-4471-2476-4_7

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-2476-4_7

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-2475-7

  • Online ISBN: 978-1-4471-2476-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics