Rhegmatogen

Rhegmatogen is a term used in ophthalmology to describe a mechanism of retinal detachment caused by a tear or break in the retina. The more common and technically correct term is rhegmatogenous. In rhegmatogenous detachment, fluid from the vitreous cavity passes through the retinal break and accumulates under the sensory retina, causing the retina to peel away from the underlying pigment epithelium.

The detachment typically begins at sites of retinal weakness or tears, which can result from degenerative changes such as lattice degeneration, posterior vitreous detachment with traction, or trauma. Risk factors include high myopia, previous cataract surgery, family history of retinal detachment, and proliferative vitreoretinopathy. The condition is usually unilateral and may progress as fluid tracks through multiple breaks.

Symptoms commonly include sudden onset of floaters, flashes of light, and a shadow or curtain over part of the visual field. If the macula becomes detached, central vision may decline. Diagnosis is made by dilated examination with ophthalmoscopy; optical coherence tomography may assess macular involvement. When the view is obscured, B-scan ultrasonography can confirm detachment and identify retinal breaks.

Treatment aims to seal the retinal breaks and reattach the retina. Approaches include laser photocoagulation or cryopexy around the breaks, scleral buckling, pars plana vitrectomy, or a combination, often with intraocular tamponade agents such as gas or silicone oil. Prognosis depends on macular status at presentation and duration of detachment; prompt treatment improves visual outcomes and reduces the risk of recurrence.

Etymology: rhegmatogenesis refers to the formation of breaks; rhegmatogenous detachment specifically denotes detachments caused by such breaks.