|Year : 1967 | Volume
| Issue : 6 | Page : 238-240
Developmental retinal detachment
KS Mehra, HV Nema, K Rajyashree, R Singh
Department of Ophthalmology, College of Medical Sciences, Banaras Hindu University, Varanasi, India
|Date of Web Publication||22-Jan-2008|
K S Mehra
Department of Ophthalmology, College of Medical Sciences, Banaras Hindu University, Varanasi
Source of Support: None, Conflict of Interest: None
|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
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|| |
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.
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|| |
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. 
| References|| |
ARRUGA H. (1950) Bull Soc. franc. Ophthal-63, 160.
DUKE-ELDER W. S. - System of Ophthalmology. Vol. III Part 2.
HENRY KIMPTON. London. 1964, p. 642.
HAMILTON (1946) Trans. Ophthal. Soc. Aust. 6, 113.
HEINE V. (1904) Grafes Arch. Ophthal. 58, 38.
HUYSMANS (1940) Ophthalmologica, 99, 449.
WILSON (1949) Cand Med. Assocn. K. 60, 580.
[Figure - 1], [Figure - 2]