Nervous tissue lining the back of the eye, the retina is a kind of photographic film that prints the images we see. In the event of a tear, the liquid contained in the eye seeps between the retina and the wall of the eye. This can cause retinal detachment.
What are the risk factors?
The risk factors for this rare disease are:
- strong myopia
- A history of retinal detachment in the other eye
- Eye surgery (cataract, vitrectomy, etc.)
- eye trauma
- The existence of another disease affecting the eye (uveitis, diabetes, etc.)
What are the warning signs?
Patients consult because they notice a sudden drop in vision or a shadow. “When we question them, they often tell us that, a few days earlier, they saw “flying flies” (or myodesopsies) or flashes (or phosphenes)” underlines Dr. Sébastien Bruneau, ophthalmologist at the Rothschild Foundation hospital ( Paris).
How is it treated?
>> Laser treatment: it may be sufficient for a retinal tear or minimal onset of detachment. The burn from the laser beam produces a scar around the lesions which prevents the retinal detachment from progressing.
>> External surgery: once the retina is detached, surgery under local anesthesia is required within 24 to 48 hours of diagnosis. Different methods exist. We can intervene without going into the eye. To bring the wall closer to the retina, we practice an indentation, that is to say that we suture a synthetic material (a “sponge”) on the wall, then we practice a cryoapplication (cold welding) or laser photocoagulation (heat welding) to heal the edges of the tear.
>> Interior surgery: the other solution is to intervene inside the eye, still under local anesthesia. “We remove the vitreous gel (vitrectomy), then, as for external surgery, we proceed to the healing of the edges of the tear by laser or cold”, specifies the expert. Finally, an “internal tamponade” is performed, i.e. a gas bubble is injected (which resolves spontaneously) or, depending on the severity of the detachment and the patient’s profile, silicone oil to press the retina against the wall of the eye. “Silicone oil requires a new operation to remove it about six months after the first surgery,” explains Dr. Bruneau.
Where is the research?
Researchers are conducting studies on the risk factors for recurrence of retinal detachment, because “despite the therapeutic arsenal available today, the risk of having to re-operate the retina concerns around 10 to 15% of patients.”
The other major line of research focuses on visual recovery. “Researchers are trying to understand why some patients recover good vision and others do not despite a short treatment time.”
