What is Tractional Retinal Detachment?

This occurs when scar tissue on the retina pulls it away from the underlying layer. It is often linked to diabetic retinopathy, where abnormal blood vessels form and create tension on the retina. Over time, this traction leads to distorted vision and progressive vision loss.

Symptoms of Tractional Retinal Detachment

• Gradual diminution of vision
• Visual field defect which usually progresses slowly
• Straight lines (scale, edge of the wall, road, etc.) that suddenly appear curved
• Central visual loss if macula is detached
• Sudden drop in vision if associated with vitreous haemorrhage

Causes of Tractional Retinal Detachment

• Proliferative retinopathy due to diabetes
• Penetrating posterior segment trauma
• Vaso-occlusive lesions leading to fibrovascular proliferation
• Other causes such as retinopathy of prematurity, familial exudative vitreo retinopathy, idiopathic vasculitis

Prevention

• Controlling the systemic parameters such as blood glucose levels and blood pressure
• Regular eye check up
• Avoiding any trauma to the eyes

Types of Tractional Retinal Detachment

It can be classified based on type of vitreoretinal traction

• Tangential- caused by the contraction of epiretinal fibrovascular membranes
• Anteroposterior- due to the contraction of fibrovascular membranes extending from the posterior retina, usually in association with the major arcades, to the vitreous base anteriorly
• Bridging(trampoline)- due to contraction of fibrovascular membranes stretching from one part of retina to another or between vascular arcades

Diagnosis

• Ophthalmoscopy (direct and indirect ophthalmoscope)
• Fundus photography and Fundus Fluorescein Angiography
• Optical Coherence Tomography (OCT)
• Ultrasound B scan