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 subretinal, 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.
Exam shows bilateral microaneurysms, hemorrhages, and neovascularization on both sides of the horizontal raphe in the absence of collateral vessels. Vitreous hemorrhage 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 nonperfusion.
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 hemorrhage, sudden loss of vision).
INVESTIGATIONS
Clinical diagnosis.
Fluorescein angiogram shows focal or multifocal areas of nonperfusion.
Ultrasonography may help identify the absence of an RD.
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