Over the past century, knowledge of the pathogenesis, risk factors, and surgical treatment of rhegmatogenous retinal detachment has increased substantially. Nevertheless, despite successful anatomical repair, some patients still experience persistent visual impairment with a major impact on their quality of life. Preventing permanent visual damage remains an important clinical challenge. In this thesis, this challenge is addressed from three perspectives: understanding the underlying mechanisms, optimizing treatment and preventive strategies. Genetic factors play a larger role than often assumed; we describe both genetic risk factors and their associated phenotypes. In addition, biochemical changes in the vitreous were identified that likely contribute to the development of retinal detachment. Treatment with air tamponade proved to be a safe and more sustainable alternative to gas. Finally, we demonstrate the importance of improved patient education. Knowledge of the warning symptoms is limited in high-risk groups, while early recognition is associated with a more successful visual prognosis.
Birgit Marlies Govers obtained her Master’s degree in Medicine, at the Radboud University in 2018. In that same year, she began her PhD research focusing on the etiology, treatment, and prevention of retinal detachment. She is currently working as a resident in the Department of Ophthalmology at Radboudumc.