Causes of exudative retinal detachment
**Core Concept**
Exudative retinal detachment occurs due to the accumulation of fluid beneath the retina, causing it to separate from the underlying retinal pigment epithelium. This is often the result of underlying inflammatory or neoplastic processes.
**Why the Correct Answer is Right**
Harada's syndrome, also known as Vogt-Koyanagi-Harada (VKH) disease, is a rare autoimmune disorder that affects the uvea and can lead to exudative retinal detachment. The disease involves a systemic inflammatory response, which causes the release of various cytokines and chemokines. These substances induce the breakdown of the blood-retinal barrier, resulting in the accumulation of fluid and the formation of exudates beneath the retina. The inflammation also leads to the activation of various immune cells, such as T lymphocytes and macrophages, which contribute to the pathogenesis of the disease.
**Why Each Wrong Option is Incorrect**
**Option A:** Central retinal artery detachment typically refers to a condition where the central retinal artery is obstructed, leading to ischemia and infarction of the inner retina. This would more likely result in a retinal infarct rather than an exudative retinal detachment.
**Option B:** Hypertensive retinopathy is characterized by the damage to the retinal vasculature due to chronic hypertension. While it can cause retinal changes such as retinal hemorrhages and optic disc edema, it is not typically associated with exudative retinal detachment.
**Clinical Pearl / High-Yield Fact**
It is essential to note that Harada's syndrome can present with a wide range of systemic and ocular manifestations, including vitiligo, alopecia, and uveitis, in addition to exudative retinal detachment.
**Correct Answer:**
β Correct Answer: C. Harada's syndrome