## Anatomy of Retinal Detachment **Key Point:** In rhegmatogenous retinal detachment (RRD), there is a separation of the **neurosensory retina** from the underlying **retinal pigment epithelium (RPE)**. This is the defining anatomical feature. ### Layers Involved The retina has multiple layers, but the critical plane of separation in RRD is: - **Neurosensory retina** (photoreceptors through nerve fiber layer) separates from - **Retinal pigment epithelium** (single layer of cells resting on Bruch's membrane) The RPE normally maintains the retina in place through: 1. Tight adhesion via Müller cells and photoreceptor outer segments 2. Active transport of fluid from subretinal space 3. Metabolic support to photoreceptors ### Why This Matters Clinically **High-Yield:** Once the neurosensory retina detaches, photoreceptors lose their blood supply from the choroid, leading to rapid photoreceptor dysfunction and irreversible damage if not reattached promptly. **Clinical Pearl:** The internal limiting membrane (ILM) remains intact in RRD—it is not the plane of separation. The ILM is the innermost boundary of the neurosensory retina. ### Contrast with Other Conditions | Condition | Plane of Separation | Mechanism | | --- | --- | --- | | Rhegmatogenous RD | Neurosensory retina from RPE | Break in retina + vitreous traction | | Tractional RD | Neurosensory retina from RPE | Scar tissue contraction (no break) | | Exudative RD | Neurosensory retina from RPE | Fluid accumulation (no break, no traction) | [cite:Parson's Diseases of the Eye 22e Ch 9] 
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