J Korean Ophthalmol Soc.  2016 Oct;57(10):1645-1650. 10.3341/jkos.2016.57.10.1645.

Case of Atrophied Retina after Retinal Detachment Reoperation

• Kang SI
• Kim YC

• KMID: 2355423
• DOI: http://doi.org/10.3341/jkos.2016.57.10.1645

Abstract

PURPOSE
To report a case of visual deterioration and atrophied retina after pars plana vitrectomy (PPV) and silicone oil tamponade for the treatment of retinal detachment with previous encircling scleral buckling.
CASE SUMMARY
A 29-year-old female visited for treatment of rhegmatogenous retinal detachment (RRD) in the right eye which was not completely resolved after encircling scleral buckling. Logarithm of minimal angle of resolution (log MAR) and best corrected visual acuity (BCVA) was 0.3. Retinal detachment from 3 to 8 O'clock without macular involvement was identified. Pars plana vitrectomy, endophotocoagulation and silicone oil tamponade were performed. During the operation, retinal dialysis and retinal break at the superonasal periphery were observed. The patient complained of central scotoma at 2 days postoperatively and hyper-reflection of the inner retina was identified on optical coherence tomography (OCT). At 2 weeks postoperatively, the OCT image revealed a thin retina and impending macular hole. After 2 months, the silicone oil was removed. Although the retina was well attached, the retina remained atrophied and the log MAR BCVA was 0.16.
CONCLUSIONS
We report a rare case with deteriorated visual acuity after PPV and silicone oil tamponade for the retreatment of RRD in an atopic dermatitis patient.

Keyword

Atopic dermatitis; Rhegmatogenous retinal detachment; Silicone oils

MeSH Terms

Adult
Dermatitis, Atopic
Dialysis
Female
Humans
Reoperation*
Retina*
Retinal Detachment*
Retinal Perforations
Retinaldehyde*
Retreatment
Scleral Buckling
Scotoma
Silicon
Silicone Oils
Silicones
Tomography, Optical Coherence
Visual Acuity
Vitrectomy
Retinaldehyde
Silicon
Silicone Oils
Silicones

Figure

• 

  Figure 1. Optical coherence tomography (OCT) findings of inferior and peripapillary fundus. (A) Preoperative findings show detached retina. (B) Postoperative day 2 findings reveal reattached retina.

• 

  Figure 2. Macular optical coherence tomography (OCT) findings. (A) Preoperative OCT shows normal structure of retina. (B) Hyperreflective inner retina and the silicone oil margin is identified at postoperative day 2. (C) The impending macular hole is revealed at postoperative 2 weeks. (D) Thin retina without macular hole is observed at postoperative 6 weeks.

• 

  Figure 3. Fluorescein angiography (FAG) and indocyanine green angiography (ICG) findings after removal of silicone oil. (A) FAG shows delayed arteriovenous transit time and patchy hypofluoroscein at posterior pole in choroidal phase, 2 days after removal of silicone oil. (B) Two weeks after removal of silicone oil, FAG shows slight hypofluorescein in choroidal back flush and some hyper-fluoroscein of stain but ICG findings is unremarkable.

Reference

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