Clinical Signs, Imaging, Diagnosis and Differential Diagnosis of Rhegmatogenous Retinal Detachment

Abstract

Photopsia, floaters, visual field defects, loss in visual acuity, periocular pain, and dyschromatopsia are symptoms of rhegmatogenous retinal detachment in which early signs are Weiss ring, pigmented cells in anterior vitreous (tobacco dust sign), a general decrease in intraocular pressure and retinal detachment in a convex configuration. On the other hand, the demarcation line, secondary retinal cysts, and proliferative vitreoretinopathy are some of the late findings of detachment. Imaging of the retina is crucial in rhegmatogenous retinal detachment. Fundus photography, wide-field imaging systems, optical coherence tomography, and fundus autofluorescence tomography are beneficial for documentation and monitoring progression. Ultrasound imaging, computerized tomography, and magnetic resonance imaging may be helpful when the retina cannot be visualized in cases like vitreous hemorrhage and dense cataract. Diagnosis can be made with indirect ophthalmoscopy with indentation, and ultrasound imaging in an opaque medium. Differential diagnosis of rhegmatogenous retinal detachment is exudative and tractional detachment, as well as lesions that can mimic retinal detachment such as retinoschisis, intraretinal macrocysts, choroidal detachment, vitreous opacities and white with or without pressure lesions.