SELECTIVE LOSS OF BLUE CONES AND RODS IN HUMAN RETINAL-DETACHMENT

Objective: To determine if there are histopathologic changes in the ou ter retina that could explain the blue-yellow color confusion previous ly described following rhegmatogenous retinal detachment in humans. Me thods: Ten eyes with traumatic retinal detachments were studied. Eight of the eyes were removed from 21/2 to 11 days following trauma. In th e remaining two eyes, the retinas were successfully reattached. Enzyme histochemical studies for carbonic anhydrase and immunochemical studi es for S antigen were performed to distinguish blue cones from red/gre en cones. Results: With the 21/2 to 4-day-old detachments, nearly all of the carbonic anhydrase-negative (blue-sensitive) cones and many of the rods were seen to have signs of irreversible necrosis, including e xtreme swelling of the inner segments and mitochondria, loss of the ou ter segments, and pyknotic and displaced nuclei. In the 6- and 11-day- old detachments, almost all of the carbonic anhydrase-negative cones a nd many rods were missing. Blue cones were essentially absent from the reattached retinas, and there were only about half the normal number of rods. Conclusions: Rhegmatogenous retinal detachment results in rap id and almost total loss of the blue cones. Significant rod loss also occurs in this type of detachment but the red/green cones are comparat ively resistant to damage. These findings could explain the observed b lue-yellow color confusion in such patients. We discuss other clinical implications.