Tabibian D Hoogewoud F Mavrakanas N Schutz JS 2015 It is widely accepted that the origin of subretinal fluid in rhegmatogenous retinal detachment (RRD) is liquid vitreous and that posterior vitreous detachment (PVD) and associated retinal tears are caused by vitreoretinal traction from intra-ocular currents, contraction of collagen fibers, and gravity. These explanations, however, are incomplete. We present a new synthesis of experimental and clinical evidence, updating understanding of fundamental pathophysiological processes in RRD. Misdirected aqueous flow is shown to more convincingly explain the origin of subretinal fluid in clinical RRD, to be the most likely cause of acute PVD and retinal tear formation, and also to contribute to initial detachment of the retina at retinal tears. Misdirected aqueous flow in RRD is a pathophysiological process, rather than the "aqueous misdirection syndrome", and occurs without visible anterior chamber shallowing or acute glaucoma. https://sonar.ch/global/documents/221641 eng info:eu-repo/semantics/altIdentifier/doi/10.1016/j.survophthal.2014.07.002 info:eu-repo/semantics/altIdentifier/pmid/25223495 Survey of ophthalmology. - 2015 aqueous misdirection pathophysiology posterior vitreous detachment retinal tear rhegmatogenous retinal detachment vitreoretinal traction Aqueous Humor Humans Retinal Detachment Retinal Perforations Subretinal Fluid Vitreous Body Vitreous Detachment Misdirected aqueous flow in rhegmatogenous retinal detachment: a pathophysiology update. http://purl.org/coar/resource_type/c_6501