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Retinal Detachment

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We are continuing to look at ocular pathology.

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In this case,

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this was a patient who developed sudden onset

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of decreased vision in the right eye.

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This was not after trauma.

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As we scroll through this case,

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we notice that there is an unusual density in the posterior

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portion of the right globe affecting the vitreous.

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As we focus on this image,

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we will look at the location of that abnormal density.

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The area that I'm talking about is this hyperdense area,

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both along the medial aspect as well as the temporal

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aspect of the globe. In this situation,

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one notes that that abnormal density,

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which is somewhat elliptical in shape,

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stops at a portion of the globe which is

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at 10 o'clock along the lateral aspect.

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When we scroll through the case

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and look at the medial aspect,

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again, it ends at an area that

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does not go up to the level of the ciliary apparatus,

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nor the lens of the globe.

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This then represents a retinal hemorrhage.

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Classically, retinal hemorrhages will show a biconvex

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appearance with the apex at the optic nerve.

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This is drawn in classically in this fashion,

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again, stopping at 10 o'clock and 2 o'clock on the globe

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but showing the apex at the optic nerve.

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This is to be contrasted with a choroidal hemorrhage.

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A choroidal hemorrhage usually is identified as going

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anteriorly to the ciliary apparatus, and it may be on both

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the medial as well as the lateral aspect of the globe

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or nasal or temporal portion of the globe.

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It extends further anterior than a retinal hemorrhage,

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which ends at the ora serrata,

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which was described on the anatomy section.

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Now, this patient's retinal detachment was not due to trauma.

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The most common cause of nontraumatic retinal

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detachment is from diabetic retinopathy.

Report

Description

Faculty

David M Yousem, MD, MBA

Professor of Radiology, Vice Chairman and Associate Dean

Johns Hopkins University

Tags

Trauma

Orbit

Neuroradiology

Neuro

Metabolic

Head and Neck

CT

Acquired/Developmental

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