# 视网膜脱离（Retina Detachment）

- 器官 / 系统：眼 / 特殊感觉系统（eye / special-senses-system）
- NTP 数据编号：ntp-0344
- 规范 URL：https://www.labsmart.cn/ntp/eye-retina-detachment.html
- 中文图谱总页锚点：https://www.labsmart.cn/ntp-atlas.html#eye-retina-detachment
- 原始出处：https://ntp.niehs.nih.gov/atlas/nnl/special-senses-system/eye/Retina-Detachment
- 授权：美国联邦政府作品，公有领域；引用请标注 NTP Nonneoplastic Lesion Atlas
- 适用说明：仅供科研使用，不用于临床诊断

## 一句话结论
视网膜脱离（retinal detachment）指视网膜下间隙的病理性扩张，视网膜部分至完全脱离其与视网膜色素上皮（retinal pigment epithelium，RPE）的正常联系。

## 病变描述（中文）
视网膜脱离（retinal detachment）指视网膜下间隙的病理性扩张，视网膜部分至完全脱离其与视网膜色素上皮（retinal pigment epithelium，RPE）的正常联系。视网膜脱离有多种原因，包括外伤性视网膜撕裂或裂孔（孔源性脱离）；异常玻璃体纤维膜的牵拉；以及视网膜下间隙的占位性物质，如浆液性或炎性渗出物、血液或肿瘤细胞。视网膜脱离也可由任何其他破坏RPE与视杆和视锥光感受器突起之间正常紧密联系的因素引起，如获得性或遗传性视网膜细胞或RPE变性；代谢性疾病；和/或视网膜或脉络膜血管系统功能障碍。病因不明的自发性脱离也可散发性发生于大鼠和小鼠。真正的脱离必须与人为分离（这是常见的死后现象）相鉴别。真正脱离的特征可包括视网膜下间隙内的液体、出血和/或炎性或肿瘤细胞，以及脱离视网膜的继发性变性（尤其是视杆和视锥光感受器）和反应性RPE肥大和/或增生。完全性视网膜脱离可形成典型的锥形或漏斗形，在显微镜横切面上呈Y形或V形构型（Figure 1、Figure 2）。大量视网膜下液体可使脱离并变性的视网膜移位，远离后极部眼底。脱离的视网膜可能发生变性，RPE可能表现为肥大和增生（Figure 2）。

## 诊断与分级建议（NTP 共识，中文）
视网膜脱离应作出诊断并赋予严重程度分级。相关病变，如RPE的肥大和增生、出血或视网膜下液体积聚，除非因严重程度需要，否则不应单独诊断，但应在病理学叙述中描述。相关病变，如炎症，应单独诊断。

## 英文原文 · Comment
Retinal detachment denotes pathologic expansion of the subretinal space, with partial to complete displacement of the retina from its normal association with the retinal pigment epithelium (RPE). Retinal detachment has many causes, including traumatic retinal tears or holes (rhegmatogenous detachment); traction by abnormal vitreal fibrous membranes; and space-occupying materials in the subretinal space, such as serous or inflammatory exudates, blood, or neoplastic cells. Retinal detachments can also result from any other factor that disrupts the normal intimate association of the RPE and the rod and cone photoreceptor processes, such as acquired or heritable retinal cell or RPE degenerations; metabolic diseases; and/or dysfunction of retinal or choroidal vasculature. Spontaneous detachments of uncertain etiology can also occur sporadically in rats and mice. True detachments must be distinguished from artifactual separation (which is a common postmortem occurrence). Features of true detachments can include fluid, hemorrhage, and/or inflammatory or neoplastic cells in the subretinal space, as well as secondary degeneration of the detached retina (especially the rod and cone photoreceptors) and reactive RPE hypertrophy and/or hyperplasia. Complete retinal detachment can result in a classic cone or funnel shape that in microscopic cross section has a Y- or V-like configuration ( Figure 1 and Figure 2 ). Large amounts of subretinal fluid may displace the detached and degenerate retina from the posterior fundus. The detached retina may be degenerate, and the RPE may exhibit hypertrophy and hyperplasia ( Figure 2 ).

## 英文原文 · Recommendation
Retinal detachment should be diagnosed and assigned a severity grade. Associated lesions, such as hypertrophy and hyperplasia of the RPE, hemorrhage, or subretinal fluid accumulation, should not be diagnosed separately unless warranted by severity, but should be described in the pathology narrative. Associated lesions, such as inflammation, should be diagnosed separately.

## 配图
- https://www.labsmart.cn/ntp-atlas-images/ntp_1003.jpg
- https://www.labsmart.cn/ntp-atlas-images/ntp_1009.jpg

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