ABLASIO RETINA

ROCHASIH MUDJAJANTI

DEFINISI

LEPASNYA LAPISAN RETINA SENSORIS

DARI EPITEL PIGMEN RETINA

KLASIFIKASI
RHEGMATOGENOUS RD TEAR (+)
TRACTIONAL RD
EXUDATIVE RD

EPIDEMIOLOGI
INSIDENSI 1 PER 10.000
BERHUBUNGAN DG MIOPIA 7%
MIOP SEDANG

Teknik pemeriksaan
Indirect Ophthalmoscopy with scleral
indentation
Indirect biomicroscopy
B-scan Ultrasound

Mekanisme ablasio retina

1- Rhegmatogenous RD:
Retinal breaks + accumulation of subretinal
fluid
Retinal breaks result from dynamic
vitreoretinal tractions(PVD) and peripheral
retinal degenerations

Komplikasi PVD
No complications: most of the time
Retinal tears:

10-15% of cases
Associated with vitreous hemorrhage
U-shaped
Risk of RD is high

Avulsion of retinal blood vessel and

vitreous hemorrhage without tear: rare

Acute posterior vitreous detachment: (a) synchisis; (b) uncomplicated

posterior vitreous detachment; (c) retinal tear formation and vitreous
haemorrhage; (d) avulsion of a retrnal blood vessel and vitreous
haemorrhage

Tipe degenerasi

Lattice Degeneration:

8% of population
40% in eyes with RD
Most common among Myopes
Shape: Spindle-shaped areas of thinnig in the
form of a network .
Overlying vitreous is synchitic but
attachments are stronger

Lattice degeneration

MYOPIA & ABLASIO RETINA

over 40% of all RDs occur in myopic eyes.

The higher the refractive error the greater the risk of RD.
The following interrelated factors predispose a myopic eye
to RD:
Lattice degeneration .
Snailtrack degeneration.
Diffuse chorioretinal atrophy may give rise to small round holes in highly myopic
eyes.
Macular holes may give rise to RD in highly myopic eyes.
Vitreous degeneration and PVD are more common.

Vitreous loss during cataract surgery, is associated with about a 15% incidence of
subsequent RD in myopic eyes greater than 6D; the risk is even higher if myopia is more
than 10D.
Posterior capsulotomy is associated with an increased risk of RD in myopic eyes.

Mekanisme ablasio retina

2- Tractional retinal detachment:
e.g. Diabetic tractional RD
Active vitreous traction
3- Exudative RD:
disorders that disrupt the retinal pigment epithelium and allow
the choroidal fluid to accumulate in the subretinal space

Causes:

Choroidal tumors
Intraocular inflammation
Iatrogenic : RD surgery
Subretinal neovascularizations

Bridging and anteroposterior vltreoretinal traction giving rise to an extensive

tractional retinal detachment in advanced proliferative diabetic retinopathy

Gambaran klinik
Rhegmatogenous RD:
Symptoms:
flashes of light(Photopsia)
Vitreous floaters(ring-shaped, cobweb, and shower of floaters)
Peripheral visual loss: relative scotoma

Signs:

Relative afferent papillary defect

Lower IOP
Vitreous opacities(tobacco dust)
Retinal breaks
Retinal appearance: convex corrugated and undulating surface

Fresh bullous superior retinal detachment

GAMBARAN KLINIK
Tractional RD:
Symptoms: photopsia and floaters are absent,
slowly progressive visual field loss
Signs: Concave immobile surface, absent retinal
breaks
Exudative retinal detachment:
Symptoms: photopsia is absent but floaters are
present(vitritis), visual field loss
Signs: Convex, smooth not corrugated, mobile with
shifting of subretinal fluid, absent retinal breaks

Combined Tractional and Rhegmatogenous RD

Choroidal Detachment

Choroidal Detachment

TATALAKSANA

RHEGMATOGEN SIMPLE SCLERAL

BUCKLING, SB + VITREKTOMI, MEMBRAN
PEELING, GAS, SILIKON OIL
TRD PADA PDR LASER FC SEBELUM SB,
VITREKTOMI, MEMBRAN PEELING
TRD DG ABLASIO RHEGMATOGEN SB,
VITREKTOMI, MEMBRAN PEELING, GAS
EKSUDATIVA FFA, USG,ERG,KONSUL
SUBBAG LAIN YG TERKAIT,TERAPI
PENYAKIT DASAR

PNEUMORETINOPEXY