Differentials
Retinoschisis
SIGNS / SYMPTOMS
Degenerative (peripheral) retinoschisis and rhegmatogenous RD can coexist in the same eye. However, retinoschisis is commonly bilateral and symmetric.
INVESTIGATIONS
Indirect ophthalmoscopy with scleral indentation and slit-lamp biomicroscopy show that the fluid is intraretinal, rather than sub-retinal, and therefore does not shift with scleral depression. There is no pigment in the vitreous cavity and the retinal surface has a 'beaten-metal' appearance.[44]
Diabetic retinopathy
SIGNS / SYMPTOMS
Usually presents symmetrically.
Examination shows bilateral microaneurysms, haemorrhages, and neovascularisation on both sides of the horizontal raphe in the absence of collateral vessels. Vitreous haemorrhage is a common complication that does not differ in presentation from that seen in conjunction with an RD.
INVESTIGATIONS
Clinical diagnosis.
Fluorescein angiogram shows multifocal areas of non-perfusion.
Ultrasonography may help identify the presence of a retinal break and the absence of an RD.
Retinal vein occlusion
SIGNS / SYMPTOMS
Clinical presentation may be similar (vitreous haemorrhage, sudden loss of vision).
INVESTIGATIONS
Clinical diagnosis.
Fluorescein angiogram shows focal or multifocal areas of non-perfusion.
Ultrasonography may help identify the absence of an RD.
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