Felis ISSN 2398-2950

Retina: detachment

Contributor(s): Dennis E Brooks, David Williams


  • Complete or partial detachment of the neurosensory retina (nsr) from the retinal pigment epithelium (rpe). Usually bilateral.
  • Cause: commonly caused by hypertension in the elderly cat. Also inflammation, trauma, neoplasia, hyperviscosity syndromes, toxicity (ethylene glycol).
  • Signs: any or all of: visual loss/compromise (often sudden onset may be difficult to appreciate if retinal detachment is unilateral), hyphema, vitreal hemorrhage, dilated pupil, leucocoria (white pupil).
  • Diagnosis: ophthalmoscopy reveals detachments and hemorrhage.
  • Treatment: depends on cause - treat primary cause and symptomatic management.
  • Prognosis: previously considered to be poor unless treatment instituted very early; degeneration of feline retina is rapid following detachment; more recently treatment of hypertensive detachments with amlodipine has resulted in recovery of sight in a significant proportion of animals.




  • Primary (spontaneous or traumatic) - secondary to systemic or ocular disease. Partial (focal or multifocal) - total.
  • Hypertension  Hypertension vascular pathology   →   incompetence and leakage of plasma and fibrinogen.
  • Fluid accumulation results in extensive bullous detachment.
  • Inflammation: inflammatory exudates localize in the potential space between neurosensory retina and retinal pigment epithelium (junction of primordial inner and outer layers of optic cup)   →   detachments.
  • Neoplasia: tumor growth may infiltrate the sub-retinal space   →   a solid, usually circumscribed, detachment.
  • Hyperviscosity syndromes: hyperproteinemia and polycythemia vera   →   detachments by causing vascular pathology as above.
  • Hypertension affects choriocapillaris first, because lacks autoregulatory control of blood flow cf. retinal vessels   →   focal hazy opacities (reflecting leakage of plasma and fibrinogen)   →   focal intra-retinal hemorrhage if further damage to vessels occurs ('dot and blot' hemorrhages)   →   ischemic damage to the retinal pigment epithelium (rpe) (very metabolically active cells)   →   sub-retinal exudation and detachment.
  • Detachment first flat, then multiple bullae (cobblestone appearance), then total.
  • Uncontrolled hypertension   →   intra-vitreal hemorrhage from retinal vessels, possible hyphema as bleeding occurs from iris vessels. Intra-ocular hemorrhage may   →   secondary glaucoma Glaucoma.
  • Hyperviscosity syndromes   →   sludging of blood in vessels   →   hypoxic damage   →   pathophysiology as for hypertension.


  • Usually 'sudden' in onset, ie sudden objective signs but this relates to the second eye affected - the first may have a chronically detached (and thus permanently damaged) retina.
  • Early signs may be picked up on examination before objective signs, eg at routine annual vaccination (a good reason for ophthalmic examination at every routine examination in the older cat).


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Further Reading


Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Littman M P (1994) Spontaneous systemic hypertension in 24 cats. JVIM (2), 79-86 PubMed.
  • Sansom J, Barnett K C, Dunn K A et al (1994) Ocular disease associated with hypertension in 16 cats. JSAP 35 (12), 604-611 VetMedResource.

Other sources of information

  • Petersen-Jones S & Crispin S (2002) BSAVA Manual of Small Animal Ophthalmology. 2nd edn. British Small Animal Veterinary Association. ISBN 0 905214 54 4