Combined Rhegmatogenous Retinal and Choroidal Detachment

Abstract

Purpose: To review the literature on eyes with concurrent rhegmatogenous retinal and choroidal detachment (RRD-CD). Methods: Several databases were searched for “rhegmatogenous retinal detachment” and “choroidal detachment” through October 2022. All English language primary literature was reviewed. Results: Studies demonstrated that eyes with RRD-CD were very uncommon and had diminished baseline visual acuity (VA) and intraocular pressure (IOP) compared with eyes with RRD only. Although no randomized trials have been performed, pars plana vitrectomy with or without scleral buckle (SB) have reported higher surgical success rates than SB alone. Reattachment rates were affected by age, IOP, adjuvant steroids, and grade of proliferative vitreoretinopathy. Conclusion: Low IOP and poor initial VA are salient features of eyes with RRD-CD. Steroids can be useful adjuvants administered safely using several routes including periocular and intravitreal injection. PPV ± SB may result in best surgical outcomes.

The role of Intravitreal Methotrexate as an Adjunct to Local or Systemic Corticosteroids in Vitrectomy for Rhegmatogenous Retinal Detachment and Choroidal Detachment: A Pilot Study

“…Recent studies report that RRDCD is seen in around 9% to 20% of RRD cases. [1][2][3]7 Although surgical advances, such as small gauge PPV and preoperative steroid use, have improved anatomical outcomes, the risk of redetachment in these eyes remains relatively high. 8 The recently reported anatomical success rates for eyes with RRDCD range from 58% to 100%, 3,4,19,20 but up to half of these cases require additional surgery to achieve anatomical success and visual recovery.…”

“…[1][2][3]7 Although surgical advances, such as small gauge PPV and preoperative steroid use, have improved anatomical outcomes, the risk of redetachment in these eyes remains relatively high. 8 The recently reported anatomical success rates for eyes with RRDCD range from 58% to 100%, 3,4,19,20 but up to half of these cases require additional surgery to achieve anatomical success and visual recovery. 3,21,22 Eyes with RRDCD are at a heightened risk of developing postoperative PVR because of preexisting inflammation and hypotony.…”

“…8 The recently reported anatomical success rates for eyes with RRDCD range from 58% to 100%, 3,4,19,20 but up to half of these cases require additional surgery to achieve anatomical success and visual recovery. 3,21,22 Eyes with RRDCD are at a heightened risk of developing postoperative PVR because of preexisting inflammation and hypotony. Postoperative PVR is the leading cause of surgical failure in these cases.…”

“…Postoperative PVR is the leading cause of surgical failure in these cases. 3,7,8 Studies have indicated that approximately 77% of postoperative PVR cases arise within 4 weeks of RD surgery, with 95% occurring within 6 weeks. 21 In our series, inferior PVR was the primary cause of recurrence in most cases.…”

“…Several risk factors may contribute to this condition, including advanced age, myopia, low intraocular pressure (IOP), multiple breaks, giant retinal tear, and macular hole. [1][2][3] Pars plana vitrectomy (PPV) remains the standard treatment for rhegmatogenous retinal detachment with choroidal detachment (RRDCD), with success rates ranging from 58% to 81%. Postoperative proliferative vitreoretinopathy (PVR) is the main cause of treatment failure.…”