RPE detachment vs. Retinal Detachment

What is the difference between an RPE detachment and a retinal detachment?

In a retinal detachment isn't there a break in the retina, which means that the RPE layer would also be invovled?

I'm really confused.....
I know that the retina is made up of layers and that the outermost layer is the RPE. Also, I seem to recall reading that there are three main types of retinal detachments: rhegmatogenous, tractional, and exudative. Where does the RPE detachment come in, can it be caused by any of the three (rhegmatogenous, tractional, or exudative) means?

Also, why is RPE more commonly associated w/ macular degeneration but retinal detachments are not?

[John C Hagan III, MD, FACS, FAAO]

In a retinal detachment the RPE is not detached and the detached part is in the sensory retina, it is much larger, usually due to a hold in the inner retina, is not associated with choroidal neovascularization and tends to get larger with time.

A RPE detachment is very small, very localized, does't tend to spread and the detachment is under the sensory retina and the RPE. it may or may not have CNV and may or may not be a threat to sight.

The two conditions are not related in cause.  a RD does not cause RPE Detchament.

Go to Google images and search the two terms and see what they look like.

JCH MD

[calofan]

Thank you for the explanation!!

[John C Hagan III, MD, FACS, FAAO]

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[curtis_80]

I'm a 31 year old male. I have been diagnosed with RPE detachment.  The treatments for this condition apparently run the risk of RPE tear. However, I noticed all studies I've found that involve tearing were about people in their 60's to 80s.

Do you know of any cases of younger adults opting for treatment, but end up with a RPE tear? If so, do you know a percentage of younger adults that experience this problem?

Many thanks in advance

[John C Hagan III, MD, FACS, FAAO]

The question is what caused the RPE tear? If it's choroidal neovascularization then treatment with lucentis or avastin or visudyne light therapy is indicated and the risks of doing nothing is higher than treatment.

I'm not sure what other treatments you could be talking about.

JCH MD

[curtis_80]

Hi,

Yes, the two types of treatments you mentioned, injection or light therapy were the ones I was talking about.

It was told to me by my (new to me) retinal specialist that my RPE detachment was not a result of choroidal neovascularization, but rather central serous chorioretinopathy.

The condition has manifested itself behind the macula and is causing blurred vision. The treatments mentioned above were the ones mentioned to me by the doctor. He warned agains the RPE tear risk for both treatments, but was not willing to give statistics on how likely a tear was.

Considering that my other (non affected) eye suffers from amblyopia, I am very concerned to take the risk of loosing sight in my only good eye. However, this RPE detachment is already causing that.  I'm trying to make to best decision possible.

Can you mention anything about the risk factors for the 3 possible scenarios I may take 1) do nothing 2) injection treatment 3) laser treatment.

Many thanks in advance,

[John C Hagan III, MD, FACS, FAAO]

There is no uniform treatment of CSR. I suggest you see a second retina Eye MD ophthalmologist for a second opinion.

JCH MD