Exudative retinal detachment (ERD) is a serious condition characterized by fluid accumulation beneath the retina, often without tears. Our network of specialists listed with Specialty Vision can help identify and treat the underlying causes effectively.
This page explains what exudative retinal detachment is, what causes it, how it shows up, how it’s diagnosed and treated, and why early care matters.
Exudative retinal detachment, also called serous retinal detachment, happens when fluid builds up under the retina without any tears or holes. This occurs when the blood-retina barrier breaks down, allowing fluid to leak into the space beneath the retina. ERD often points to an underlying condition, like inflammation, tumors, or vascular diseases. Understanding how and why this detachment happens can help people recognize symptoms early and get timely treatment to protect their vision.
ERD starts when the barrier that keeps blood and retinal tissue apart begins to break down. This can happen due to:
As this barrier weakens, fluid from the choroid or retina begins to collect under the retina. This buildup lifts the retina, even though it hasn’t torn. One thing that makes ERD stand out is how it looks. On examination, the retina appears smoothly elevated, often in a dome shape. This helps doctors tell it apart from other types of retinal detachment that involve retinal breaks.
Certain inflammatory conditions are well-known triggers for ERD. Inflammatory diseases can disrupt the blood-retina barrier by promoting inflammation that leads to increased vascular permeability. Key conditions include:
A systemic autoimmune disease affecting pigmented tissues, which can result in retinal detachment if not managed properly.
Inflammation of the sclera at the back of the eye, which may indirectly cause ERD due to inflammatory leakage.
A systemic disorder that produces small clusters of inflammatory cells, potentially disrupting retinal integrity.
An infectious condition that frequently causes inflammation in the eye, leading to fluid leakage.
Systemic infectious diseases that can affect the eye and alter the blood-retinal barrier function.
Cancerous processes can also be the primary drivers behind ERD. These neoplastic causes can include:
A malignant tumor in the choroid can disrupt the delicate balance of fluid by damaging the local tissue structures.
When cancer from another part of the body spreads to the eye, it may lead to leakage and accumulation of fluid beneath the retina.
Blood-related cancers that can involve the eye and interfere with normal retinal adhesion.
Vascular abnormalities are another significant group of conditions that may result in ERD. These include:
Often seen in younger adults, CSCR leads to a buildup of fluid under the retina due to leakage from choroidal vessels.
High blood pressure can affect the retinal and choroidal circulation, leading to leakage and fluid accumulation.
These pregnancy-related conditions can cause sudden changes in vascular pressure that impact the eye.
In some cases, ERD arises due to factors related to medical or surgical interventions, or without a clearly identified cause:
Following procedures such as scleral buckle or other intraocular surgeries, inflammation can sometimes lead to ERD.
Although rare, ERD can occur without any identifiable underlying condition, leaving its cause unknown.
Symptoms of ERD can be subtle at first and may vary depending on how much of the retina is affected and for how long. Many patients don’t notice anything until the detachment starts to interfere with central or peripheral vision.
During an eye exam, retina specialists often spot a smooth, dome-shaped elevation of the retina. A key clue is that the fluid under the retina shifts when the patient changes head position, something that helps distinguish ERD from other types of detachment, which involve retinal tears or holes.
The most common symptom. Vision may fade gradually or suddenly, but there’s usually no pain.
Straight lines may appear wavy, bent, or warped especially when the macula is involved.
You may notice missing patches or shadows in your vision due to retinal areas no longer functioning normally.
Less common in ERD, but flashes may occur if fluid is irritating nearby retinal tissues.
Colors may look washed out or dull, especially in areas where the retina is detached.
If you're experiencing symptoms related to vision changes, don’t hesitate to contact a qualified eye care professional. Practices listed with Specialty Vision include renowned specialists in retinal health who can offer tailored treatment options for exudative retinal detachment. Find a top optometrist or ophthalmologist near you today!
You might notice a dark area or shadow, often described as a curtain or veil, in your side or central vision.
When fluid collects under the central retina (macula), it can make it hard to read, focus on faces, or see fine details.
ERD is usually caused by an underlying condition, so treatment focuses on identifying and managing that root issue. Here's how it's typically approached based on the cause:
Steroids either taken by mouth, injected around the eye, or directly into the eye, are often the first treatment. In more stubborn cases, immunosuppressants may be needed to reduce inflammation and help restore the blood-retina barrier.
If ERD is linked to a tumor, the patient is referred to an oncology team. Treatment may include radiation, chemotherapy, or other cancer-specific approaches.
Conditions like central serous chorioretinopathy (CSCR) or hypertensive choroidopathy are managed by controlling blood pressure and reviewing medications that may be contributing to the problem.
When infection is the cause, targeted antibiotics or antivirals are used to fight the source of inflammation and stop the fluid buildup.
If ERD develops after eye surgery, anti-inflammatory medications and careful monitoring are usually enough to resolve the problem.
Surgery for ERD is uncommon and used only when other treatments don’t work. Surgery is typically a last resort. Most cases of ERD improve with medication and close monitoring. The goal is always to treat the cause and avoid unnecessary procedures whenever possible. It may be considered in the following situations:
If the retina remains detached despite medical treatment, surgery might be needed.
If a tumor is suspected, removing and analyzing a small sample from inside the eye can help confirm the diagnosis.
In certain cases, especially when fluid buildup is affecting central vision, draining the fluid can help restore the retina's normal position.
The most common symptoms include painless visual loss, blurring, distorted vision (metamorphopsia), and sometimes blind spots (scotomas). While some patients may also see flashes of light, this symptom is less common compared to others. A careful examination by our retina specialists is necessary to determine if these symptoms are due to ERD or another ocular condition.
In exudative retinal detachment, the retina detaches because of the accumulation of fluid without any retinal tears or holes. This is in contrast to other detachments like rhegmatogenous retinal detachment, where an actual break in the retina allows fluid to seep underneath. This difference is critical since it guides the approach to both diagnosis and treatment.
In certain cases, such as those related to central serous chorioretinopathy, ERD can resolve with careful observation and regular monitoring. However, because the underlying causes can vary, it’s essential to work closely with our retina specialists to determine the best management plan for each individual situation.
Diagnosis typically involves a detailed examination of the retina through advanced imaging techniques such as OCT, FFA, and ICGA. In cases where visualization is difficult, a B-scan ultrasonography might be employed. In addition, our retina specialists may order laboratory tests or collaborate with other specialists if a systemic condition is suspected.
Treatment centers on addressing the underlying condition causing the ERD. This can include anti-inflammatory medications, immunosuppressants, measures to control blood pressure, or targeted therapies for infections or neoplastic processes. In rare cases, surgical intervention may be considered if other measures do not resolve the detachment.
If you're experiencing symptoms related to vision changes, don’t hesitate to contact a qualified eye care professional. Practices listed with Specialty Vision include renowned specialists in retinal health who can offer tailored treatment options for exudative retinal detachment. Find a top optometrist or ophthalmologist near you today!
Learn about exudative retinal detachment (ERD), its causes, symptoms, and treatment options. Find reliable specialists listed with Specialty Vision.
