What leads to the development of rhegmatogenous retinal detachment during posterior vitreous detachment?

The development of rhegmatogenous retinal detachment during posterior vitreous detachment is primarily associated with a strong vitreo-retinal connection leading to a full thickness tear. When the vitreous gel separates from the retina, particularly in cases where it is firmly adhered at certain points, this may create tension. If the connection is robust, the traction exerted can result in a break in the retina, allowing fluid from the vitreous cavity to enter underneath the retina, leading to a separation. This mechanism is a critical factor in the pathology of rhegmatogenous retinal detachment.

A weak vitreo-retinal connection would be less likely to cause a retinal tear, as there would not be enough traction to disrupt the retinal tissue. Similarly, while increased vitreous pressure may contribute to other ocular issues, it is not the primary mechanism leading to detachment in the setting of posterior vitreous detachment. Age-related cell degeneration can contribute to changes in the vitreous and increase the chances of detachment, but it does not describe the mechanical interaction occurring during sudden posterior vitreous detachment that leads to full-thickness retinal tears. Thus, the interaction of strong adherence and the resulting mechanical stress is central to understanding why a full-thickness tear leads to rhe