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ARTICLE
Year : 1967  |  Volume : 15  |  Issue : 6  |  Page : 238-240

Developmental retinal detachment


Department of Ophthalmology, College of Medical Sciences, Banaras Hindu University, Varanasi, India

Date of Web Publication22-Jan-2008

Correspondence Address:
K S Mehra
Department of Ophthalmology, College of Medical Sciences, Banaras Hindu University, Varanasi
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Mehra K S, Nema H V, Rajyashree K, Singh R. Developmental retinal detachment. Indian J Ophthalmol 1967;15:238-40

How to cite this URL:
Mehra K S, Nema H V, Rajyashree K, Singh R. Developmental retinal detachment. Indian J Ophthalmol [serial online] 1967 [cited 2020 Apr 10];15:238-40. Available from: http://www.ijo.in/text.asp?1967/15/6/238/38817

Congenital non-attachment of retina is a known clinical entity and is the result of unequal rate of growth of the two layers of optic vesicle resulting in the failure of coaptation of the layers. DUKE-ELDER has also mentioned another condition known as develop­mental type of detachment which is usually seen in males and is the result of the rupture of the congenital cyst. HUYSMANS, ARRUGA and WIL­SON have reported such cases. Ac­cording to HEINE these primary re­tinal cysts are seen at the periphery and are present in both the eyes in symmetrical positions. These retinal cysts may progress and result in reti­noschisis. This type of retinoschisis is usually seen in hypermetropes and is bilaterally, symmetrically placed in in­ferior temporal quadrants of the eye­balls. It is a slowly progressive condi­tion and the patient may retain useful vision till adult life. In most of such cases these give rise to retinal disinser­tions at the periphery. In this condi­tion true retinal detachment is rare. HAMILTON has reported that such patients also have congenital cystic dis­ease of lungs. Not many such cases have been reported in the liaerature.

The purpose of this paper is to pre­sent a case of a young boy who had extensive retinal detachment with reti­nal disinsertions in both eyes.


  Case Report Top


A male child, aged 5 years, was ad­mitted with the complaints of gradual diminution of vision in both eyes for the last two years. Since eighteen months he was having flashes of light in front of both the eyes. The inten­sity and duration of these flashes had been more or less constant. There was no history of any trauma or any other eye disease in the past.

The patient had two elder brothers and one younger sister. The father of the patient had died 10 years back while the mother is still alive. Ac­cording to history given by the grand­mother, no other member in the family had any eye disease. The bro­thers and sister of the patient could not be examined as they were living at a great distance and did not come to hospital inspite of all our requests.

General systemic examinations did not reveal any abnormality.

Local examination:

Vision R.E. 5/60. Retinoscopy + 4.0 D. No improve­ment with glasses.

L.E. 6/60. Retinoscopy + 4.0 D. No improve­ment with glasses.

Ocular findings: Nothing abnormal was detected in the external examina­tion of the eyes. Ocular movements and tension were normal.

The pupils were round, semi-dilat­ed and sluggish in reaction.

The field of vision could not be examined due to poor co-operation.

Ophthalmoscopy: The discs were normal in colour, margins well-defined, arterial venous ratio was normal.

Extensive retinal detachment was present starting centrally near the lower margin of disc and extending upto periphery nasally along the 2.30 meri­dian and on temporal side along the 11.30 meridian, while the lower limit was upto the periphery. Five disc dia­meters from the disc in the 11.30 meri­dian, there were whitish veils present along the branch of superior temporal vein. In the detached area the retinal blood vessels were tortuous. The de­tachment was shallow towards the disc but gradually became deeper to­wards the periphery and downwards. There were two retinal holes present-­Retinal disinsertion in the lower half at the extreme periphery from 4.30 to 7 o'clock meridians and another one from 7.30 to 10 o'clock meridian. In between these two retinal disinsertions a portion of retina had remained in position. The margins of disinsertion were well defined and there were greyish bands along the margins of the retinal disinsertion towards the disc side. [Figure - 1].

Left Eye: Disc normal. Arterio-venous ratio normal.

Extensive retinal detachment was present extending from the disc mar­gin upto the periphery. The upper temporal limit of the detachment was along the 2.30 meridian while the up­per nasal limit was along the 9.30 meridian and the lower limit was all along the periphery. Detachment was shallow towards the disc but gradually became deeper towards the periphery and downwards. Retinal disinsertion was present at the extreme periphery in the down and out quadrant from the 3.30 o'clock to 5.30 o'clock meridians and white striae were present along the margins of disinsertion. [Figure - 2].


  Discussion Top


Our case was young, hypermetropic and no history of trauma was present. He had quite symmetrical disinsertions at the periphery and in the down and out quadrants of both the eyes. At top of it, besides these peripherial re­tinal disinsertions he had extensive re­tinal detachment present extending quite near to disc and involving a good amount of retina. In the right eye a translucent veil like membrane was also present. So, it appears that this case to start with had congenital re­tinal cysts, which led to retinoschisis and which finally resulted in retinal detachment and retinal disinsertions. [7]

 
  References Top

1.
ARRUGA H. (1950) Bull Soc. franc. Ophthal-63, 160.  Back to cited text no. 1
    
2.
DUKE-ELDER W. S. - System of Ophthalmology. Vol. III Part 2.  Back to cited text no. 2
    
3.
HENRY KIMPTON. London. 1964, p. 642.  Back to cited text no. 3
    
4.
HAMILTON (1946) Trans. Ophthal. Soc. Aust. 6, 113.  Back to cited text no. 4
    
5.
HEINE V. (1904) Grafes Arch. Oph­thal. 58, 38.  Back to cited text no. 5
    
6.
HUYSMANS (1940) Ophthalmologica, 99, 449.  Back to cited text no. 6
    
7.
WILSON (1949) Cand Med. Assocn. K. 60, 580.  Back to cited text no. 7
    


    Figures

  [Figure - 1], [Figure - 2]



 

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