A 55-year-old myopic patient develops sudden flashing lights followed by a shower of floaters and a curtain-like shadow from below in one eye. On fundus examination the retina is elevated with an underlying subretinal fluid and a horseshoe tear at the supero-temporal periphery. What is the pathophysiology of this detachment?

• A Exudative detachment from subretinal accumulation of fluid secondary to choroidal disease
• B Rhegmatogenous detachment from liquefied vitreous gaining access through a retinal break ✓
• C Tractional detachment due to fibrovascular proliferative membrane pulling the retina
• D Degenerative retinoschisis splitting the retina at the outer plexiform layer

Explanation

Rhegmatogenous retinal detachment (RRD) is the most common type and occurs when a break (rhegma) in the retina allows liquefied vitreous to pass into the subretinal space, separating the neurosensory retina from the RPE. Horseshoe or 'U'-shaped tears at the periphery caused by vitreoretinal traction are the most common precursor lesion. Photopsia (flashing lights) results from mechanical stimulation of photoreceptors by vitreous traction, and floaters represent vitreous condensation or hemorrhage from vessel tearing.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.