FOLLOW-UP OF A FULL-THICKNESS MACULAR FOLD FOLLOWING VITRECTOMY FOR RHEGMATOGENOUS RETINAL DETACHMENT

Detalhes bibliográficos
Autor(a) principal: Carreira, Ana Rita
Data de Publicação: 2020
Outros Autores: Loureiro, Tomás, Lopes, Diogo, Moraes, Filipe, Cardoso, João, Campos, Nuno
Tipo de documento: Relatório
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.48560/rspo.20465
Resumo: Purpose: Retinal folds (RF) are an underestimated complication of rhegmatogenous retinal detachment (RRD) surgery. Our aim was to report a case of spontaneous resolution of a full-thickness RF with foveal involvement following an uncomplicated pars plana vitrectomy (PPV) with intraocular gas tamponade for a superior on-macula RRD.   Materials and Methods: Case report.   Results: A 61-year old male underwent PPV with fluid-air exchange and intraocular gas tamponade (SF6) in the left eye for a superior on-macula RRD with vitreous hemorrhage. At the end of surgery, the retina was attached with very marginal subretinal fluid. He assumed face down positioning immediately after surgery, followed by right cheek-to-pillow positioning a few hours later. One week later, the retina remained attached but the patient had developed a mildly symptomatic full-thickness RF with foveal involvement confirmed by optic coherence tomography (OCT). A conservative approach was carried out, with spontaneous progressive anatomical and functional improvement. Two months after surgery, there was only a residual RF on fundus examination and OCT and autofluorescence were unremarkable. The patient was asymptomatic and best corrected visual acuity was 20/25.   Conclusion: Full-thickness macular folds following RRD surgery may be present even after on macula RRD repair. Our case report illustrates that they may have a spontaneous regression with complete functional recovery, in accordance with a few other publications on this topic. As such, conservative management might be indicated even in full-thickness RF if the patient has few complaints and a reasonable visual function.   Keywords: retinal detachment surgery, residual subretinal fluid, intraocular gas tamponade, retinal fold, full-thickness macular fold
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spelling FOLLOW-UP OF A FULL-THICKNESS MACULAR FOLD FOLLOWING VITRECTOMY FOR RHEGMATOGENOUS RETINAL DETACHMENTComunicações Curtas e Imagens em OftalmologiaPurpose: Retinal folds (RF) are an underestimated complication of rhegmatogenous retinal detachment (RRD) surgery. Our aim was to report a case of spontaneous resolution of a full-thickness RF with foveal involvement following an uncomplicated pars plana vitrectomy (PPV) with intraocular gas tamponade for a superior on-macula RRD.   Materials and Methods: Case report.   Results: A 61-year old male underwent PPV with fluid-air exchange and intraocular gas tamponade (SF6) in the left eye for a superior on-macula RRD with vitreous hemorrhage. At the end of surgery, the retina was attached with very marginal subretinal fluid. He assumed face down positioning immediately after surgery, followed by right cheek-to-pillow positioning a few hours later. One week later, the retina remained attached but the patient had developed a mildly symptomatic full-thickness RF with foveal involvement confirmed by optic coherence tomography (OCT). A conservative approach was carried out, with spontaneous progressive anatomical and functional improvement. Two months after surgery, there was only a residual RF on fundus examination and OCT and autofluorescence were unremarkable. The patient was asymptomatic and best corrected visual acuity was 20/25.   Conclusion: Full-thickness macular folds following RRD surgery may be present even after on macula RRD repair. Our case report illustrates that they may have a spontaneous regression with complete functional recovery, in accordance with a few other publications on this topic. As such, conservative management might be indicated even in full-thickness RF if the patient has few complaints and a reasonable visual function.   Keywords: retinal detachment surgery, residual subretinal fluid, intraocular gas tamponade, retinal fold, full-thickness macular foldObjetivos: As pregas retinianas (PR) constituem uma complicação subestimada da cirurgia de descolamento de retina regmatogénico (DRR). O nosso objetivo foi descrever um caso de resolução espontânea de uma PR de espessura completa secundária a uma vitrectomia via pars plana (VVPP) não complicada com tamponamento intraocular com gás por DRR superior.   Materiais e Métodos: Caso clínico.   Resultados: Um homem de 61 anos foi submetido a uma VVPP com tamponamento intraocular com SF6 por um DRR superior com mácula-on com hemovítreo no olho esquerdo. No final da cirurgia, a retina estava aplicada com uma quantidade residual de líquido subretiniano. O paciente assumiu o posicionamento de decúbito ventral imediatamente após a cirurgia, seguido de decúbito lateral direito dentro de algumas horas. Uma semana depois, a retina mantinha-se aplicada, contudo tinha-se desenvolvido uma PR de espessura completa discretamente sintomática com envolvimento foveal confirmado por tomografia de coerência ótica (OCT). Adotou-se uma abordagem conservadora, com melhoria funcional e anatómica espontânea progressiva. Dois meses após a cirurgia, detetava-se apenas uma PR residual na fundoscopia, e o OCT e autofluorescência não apresentavam alterações foveais. O doente apresentava-se assintomático e com melhor acuidade visual corrigida de 20/25.   Conclusões: PR de espessura completa podem ocorrer mesmo após cirurgia de DRR com mácula-on. O nosso caso clínico demonstrou que estas podem ter uma regressão espontânea com recuperação functional completa, em concordância com outras publicações neste âmbito. Assim, a abordagem conservadora pode estar indicada mesmo em PR de espessura completa em casos pouco sintomáticos e com uma função visual razoável.   Palavras-chave: cirurgia de descolamento de retina, líquido subretiniano residual, prega retiniana, prega foveal de espessura completa, tamponamento intraocular com gásAjnet2020-12-29T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/reporthttps://doi.org/10.48560/rspo.20465eng1646-69501646-6950Carreira, Ana RitaLoureiro, TomásLopes, DiogoMoraes, FilipeCardoso, JoãoCampos, Nunoinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2022-09-22T17:06:12Zoai:ojs.revistas.rcaap.pt:article/20465Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:01:44.839852Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv FOLLOW-UP OF A FULL-THICKNESS MACULAR FOLD FOLLOWING VITRECTOMY FOR RHEGMATOGENOUS RETINAL DETACHMENT
title FOLLOW-UP OF A FULL-THICKNESS MACULAR FOLD FOLLOWING VITRECTOMY FOR RHEGMATOGENOUS RETINAL DETACHMENT
spellingShingle FOLLOW-UP OF A FULL-THICKNESS MACULAR FOLD FOLLOWING VITRECTOMY FOR RHEGMATOGENOUS RETINAL DETACHMENT
Carreira, Ana Rita
Comunicações Curtas e Imagens em Oftalmologia
title_short FOLLOW-UP OF A FULL-THICKNESS MACULAR FOLD FOLLOWING VITRECTOMY FOR RHEGMATOGENOUS RETINAL DETACHMENT
title_full FOLLOW-UP OF A FULL-THICKNESS MACULAR FOLD FOLLOWING VITRECTOMY FOR RHEGMATOGENOUS RETINAL DETACHMENT
title_fullStr FOLLOW-UP OF A FULL-THICKNESS MACULAR FOLD FOLLOWING VITRECTOMY FOR RHEGMATOGENOUS RETINAL DETACHMENT
title_full_unstemmed FOLLOW-UP OF A FULL-THICKNESS MACULAR FOLD FOLLOWING VITRECTOMY FOR RHEGMATOGENOUS RETINAL DETACHMENT
title_sort FOLLOW-UP OF A FULL-THICKNESS MACULAR FOLD FOLLOWING VITRECTOMY FOR RHEGMATOGENOUS RETINAL DETACHMENT
author Carreira, Ana Rita
author_facet Carreira, Ana Rita
Loureiro, Tomás
Lopes, Diogo
Moraes, Filipe
Cardoso, João
Campos, Nuno
author_role author
author2 Loureiro, Tomás
Lopes, Diogo
Moraes, Filipe
Cardoso, João
Campos, Nuno
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Carreira, Ana Rita
Loureiro, Tomás
Lopes, Diogo
Moraes, Filipe
Cardoso, João
Campos, Nuno
dc.subject.por.fl_str_mv Comunicações Curtas e Imagens em Oftalmologia
topic Comunicações Curtas e Imagens em Oftalmologia
description Purpose: Retinal folds (RF) are an underestimated complication of rhegmatogenous retinal detachment (RRD) surgery. Our aim was to report a case of spontaneous resolution of a full-thickness RF with foveal involvement following an uncomplicated pars plana vitrectomy (PPV) with intraocular gas tamponade for a superior on-macula RRD.   Materials and Methods: Case report.   Results: A 61-year old male underwent PPV with fluid-air exchange and intraocular gas tamponade (SF6) in the left eye for a superior on-macula RRD with vitreous hemorrhage. At the end of surgery, the retina was attached with very marginal subretinal fluid. He assumed face down positioning immediately after surgery, followed by right cheek-to-pillow positioning a few hours later. One week later, the retina remained attached but the patient had developed a mildly symptomatic full-thickness RF with foveal involvement confirmed by optic coherence tomography (OCT). A conservative approach was carried out, with spontaneous progressive anatomical and functional improvement. Two months after surgery, there was only a residual RF on fundus examination and OCT and autofluorescence were unremarkable. The patient was asymptomatic and best corrected visual acuity was 20/25.   Conclusion: Full-thickness macular folds following RRD surgery may be present even after on macula RRD repair. Our case report illustrates that they may have a spontaneous regression with complete functional recovery, in accordance with a few other publications on this topic. As such, conservative management might be indicated even in full-thickness RF if the patient has few complaints and a reasonable visual function.   Keywords: retinal detachment surgery, residual subretinal fluid, intraocular gas tamponade, retinal fold, full-thickness macular fold
publishDate 2020
dc.date.none.fl_str_mv 2020-12-29T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
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