Retinal Dialysis

Overview

Retinal dialysis is most commonly associated with ocular trauma in young people. It occurs when the retina is separated from the pars plana at the ora serrata, leading to a circumferential retinal break.

Retinal dialysis occurs within the vitreous base. It can be confused with a giant retinal tear which is also associated with trauma and retinal detachment, but a giant retinal tear occurs posterior to the vitreous base insertion.

Case Example

  • Case 1

    A 22-year-old male with a history of blunt trauma to his right eye. He reports experiencing blurry vision since that incident approximately 2 years prior. His best corrected visual acuity is 6/38-1 (20/125-1) in the right eye.

    Fundus photograph and red-free image (right eye)

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    Fundus photograph and red-free image (right eye)

    Retinal photos show parallel, diagonal white lines in the infero-temporal macula and retina representing wrinkles in the neurosensory retina associated with retinal dialysis secondary to blunt trauma. The retina in this area has a white-grey appearance. There are radial lines radiating emanating from the macula and adjacent to the optic disc indicating further retinal distortion in these areas.

    Optomap pseudocolour widefield image (right eye)

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    Optomap pseudocolour widefield image (right eye)

    Widefield imaging shows a retinal dialysis in the infero-temporal quadrant and an associated retinal detachment presenting with retinal wrinkling and opacification. A large flap of retinal tissue can be seen in this image.

    Green separation image (right eye)

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    Green separation image (right eye)

    Green separation helps visualisation of the retinal dialysis and folds.

Differential Diagnosis

Commotio retinae

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Retinoschisis

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References

Chang, J. S., Marra, K., Flynn, H. W., Jr, Berrocal, A. M., & Arroyo, J. G. (2016). Scleral Buckling in the Treatment of Retinal Detachment Due to Retinal Dialysis. Ophthalmic surgery, lasers & imaging retina, 47(4), 336–340.

H. Dunbar Hoskins Jr., MD Center for Quality Eye Care (2019) Posterior Vitreous Detachment, Retinal Breaks, and Lattice Degeneration Preferred Practice Pattern. American Academy of Ophthalmology.