Clinical meaning
Retinal detachment occurs when the neurosensory retina separates from the underlying retinal pigment epithelium (RPE), disrupting photoreceptor nutrition and oxygen supply. The retina's outer segments (rods and cones) depend on the RPE for metabolic support, phagocytosis of shed photoreceptor outer segments, and vitamin A metabolism. Three types exist: rhegmatogenous (most common) occurs when a retinal break allows vitreous fluid to enter the subretinal space, separating the layers—this is often precipitated by posterior vitreous detachment where the vitreous gel separates from the retina, creating traction tears; tractional detachment occurs when fibrovascular proliferative membranes (as in proliferative diabetic retinopathy) pull the retina away from the RPE without a break; exudative detachment results from subretinal fluid accumulation from choroidal tumors, severe hypertension, or inflammatory conditions. Without reattachment, photoreceptor cell death progresses from the periphery toward the macula. If the macula detaches, central vision loss is often permanent even with successful surgical repair, making rapid recognition and intervention critical.