This patient with multiple retinal holes has a well demarcated retinal detachment.
Learning Points:
The normal neurosensory retina remains attached to the RPE due to numerous physiologic mechanisms including the inner (retinal vascular endothelium) and outer (tight junctions at the apex of the RPE cells) blood retinal barriers, hyperosmotic choroid passively drawing fluid into the subretinal space, RPE pump, interphotoreceptor matrix, and friction between the RPE microvilli and the photoreceptor outer segments.
Rhegmatogenous retinal detachment (RRD) occurs when liquid vitreous, entering the subretinal space through a retinal break, overwhelms these forces favoring retinal detachment.
Pigmented demarcation lines can form in a chronic RRD and limit the spread of subretinal fluid.
