A mathematical determination of foveal attachment in primary rhegmatogenous retinal detachment when obscured by bullous retina
Date
03/02/2022Metadata
Show full item recordAbstract
In primary rhegmatogenous retinal detachment (RRD), the foveal attachment is an important prognostic factors for post-operative vision. When the fovea is obscured by the RRD, its attachment status is considered uncertain. Using a model of the reduced emmetropic and − 10 dioptre myopic eye and the physical properties of the detached retina, we aimed to mathematically ascertain if it is clinically possible for the fovea to be attached while it is obscured by the primary RRD. With the patient upright, a primary RRD due to a 12 o’clock break directly above the fovea was considered. Mathematically, once the trough of the RRD touches the visual axis the edge of the RRD nearest to fovea is 2.77mm away from fovea in emmetropic eye and 2.89mm in myopic eye. When the RRD reaches the fovea, its trough is 2.20 mm below the visual axis in emmetropic eye and 2.29 mm in myopic eye. However, in vivo the RRD makes an acute angle with the retinal pigment epithelium and the corrugation of the retina in RRD shortens the retina. When these in vivo constraints are considered, in both of the above situations the fovea will be detached. If the fovea is obscured by an RRD, the fovea is very likely to be detached. In idiomatic terms, if the fovea cannot be seen, the fovea cannot see. This is an important clinical diagnosis for appropriate triage of the patient.
Citation
Kousha , O , Tarafdar , S & Ellis , J 2022 , ' A mathematical determination of foveal attachment in primary rhegmatogenous retinal detachment when obscured by bullous retina ' , International Journal of Retina and Vitreous , vol. 8 , 10 . https://doi.org/10.1186/s40942-022-00359-3
Publication
International Journal of Retina and Vitreous
Status
Peer reviewed
ISSN
2056-9920Type
Journal article
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