Exudative retinal detachment which is a result of fluid that accumulates under the retina without a retinal tear or the pulling which is seen in tractional detachment. The retina is the light sensitive tissue at the back of the eye which when it detaches from its support structure may cause impairment to vision. Exudative RD may also occur when blood vessels let out fluid, when the blood retinal barrier is affected by inflammation or in other ophthalmic or systemic health conditions which promote abnormal fluid collection.
The National Eye Institute report on retinal detachment types National Eye Institute Types and Causes of Retinal Detachment reports that exudative retinal detachment is a result of fluid accumulation behind the retina which does not have a break or tear. Also any retinal detachment may put your sight at risk which is why you should get in to see the eye care professional at the first sign of changes in your vision.
What Is Exudative Retinal Detachment?
Exudative retinal detachment what is also referred to as serous retinal detachment. Fluid builds up in the space between the sensory retina and the retinal pigment epithelium. That is as opposed to rhegmatogenous detachment which is characterized by a retinal break, and tractional detachment which is a result of scar tissue pulling the retina away. As exudative RD may present from a number of diseases the main goal of the treatment is to determine the cause.
| Type | What Happens | Main Mechanism |
| Exudative | Fluid gathers beneath the retina without a tear | Leakage or inflammation |
| Rhegmatogenous | Fluid enters through a retinal tear | Retinal break |
| Tractional | Retina is pulled from its position | Scar tissue or traction |
Exudative Retinal Detachment Causes
The exudative retinal detachment causes inflammation within or behind the eye, leaking retinal or choroidal blood vessels, eye tumors, injury, infection and some systemic vascular diseases. Also associated are posterior scleritis, Vogt-Koyanagi-Harada disease, Coats disease and certain choroidal tumors.
The specific cause does matter as treatment options may be very different. In one case it may be a matter of inflammation, in another a result of vascular leakage or a mass. That is why evaluation by an ophthalmologist should be the rule rather than treatment based on symptoms alone.
Symptoms of Exudative Retinal Detachment
Symptoms may present as blurred vision, reduced vision, distortion, floaters, a shadow in part of the visual field or loss of peripheral vision. Some see a gradual progression or variable change instead of a sudden serious incident.
Patients who have exudative RD should not delay treatment as pain may not be a feature. Vision loss which is progressive, a curtain like shadow, acute vision drop, flashes or an increase in floaters should be brought to medical attention immediately.
| Possible Symptom | What a Patient May Notice |
| Blurred vision | Fine details become unclear |
| Distortion | Straight lines may look bent |
| Peripheral field loss | A side area appears missing or shadowed |
| Floaters | Moving spots or shapes appear |
How Is Exudative Retinal Detachment Diagnosed?
Diagnosis of exudative retinal detachment usually begins with a health history and retinal exam which is dilated. The specialist reports on subretinal fluid and also notes any retinal breaks, traction, inflammation, or other abnormalities. At Vasan Eye Care we may use retina test like OCT, fundus imaging or B-scan ultrasonography. Angiography may be used in the case of vascular or choroidal leakage which require a more in depth study.
If at the root of the issue is a systemic condition we may run some blood tests or in some cases medical imaging. We do this to confirm the diagnosis and identify what is causing the fluid. The NCBI Bookshelf clinical review also reports that which tests to order should be based on the physical exam results and what we suspect the underlying disease to be.
Exudative Retinal Detachment Treatment
Treatment is directed at the base of the disease. In the case of inflammation we may see the use of anti-inflammatory and immunosuppressive drugs. As for vascular issues we may require retinal laser, photodynamic therapy or intravitreal injection as treatments; and for infections and tumors we give cause specific care.
Unlike in the case of tear related detaching this does not play out the same for this condition which may in fact have no tear to repair. Surgery is an option in selected or treatment resistant cases. What we do depends on the degree of severity, macular involvement and the exudative retinal detachment causes.
Retina Care at Vasan Eye Care
At Vasan Eye Care we see patients with what we think may be a case of exudative retinal detachment in which we do retina assessment and imaging to determine the type and cause of the issue. We have retina services at Vasan Eye Care which include specialist review that in turn will help us to put together an appropriate treatment plan. Early in the evaluation process is key because the outcome is based on the disease which caused it and how fast we can get it under control.
What we learn from the base disease also is the reason that for some patients we may recommend medicine and for others laser, injection or very rarely retinal surgery. At Vasan Eye Care we do Retinal Surgery.
Frequently Asked Questions
1. What is exudative retinal detachment?
Exudative retinal detachment is when there is a separation of the retina which does not result from a tear or traction.
2. Is exudative RD serious?
Yes. Exudative RD may put vision at risk and requires prompt ophthalmic assessment.
3. What are common exudative retinal detachment causes?
Common exudative retinal detachment causes include inflammation, vascular leakage, tumors, trauma and infection.
4. Can exudative retinal detachment improve without surgery?
Yes. In many cases improvement occurs when the base disease is successfully treated.
5. Which tests are used?
A detailed retinal exam is key which in many cases is supported by OCT, fundus imaging, angiography or ultrasound.