Two Cases of Outer Retinal Folds Developing after Vitrectomy in Patients Exhibiting Rhegmatogenous Retinal Detachment

Jung Hoo Lee; Chang Ki Yoon; Hyun Woong Kim

doi:10.3341/jkos.2018.59.4.379

Journal List > J Korean Ophthalmol Soc > v.59(4) > 1010891

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Lee, Yoon, and Kim: Two Cases of Outer Retinal Folds Developing after Vitrectomy in Patients Exhibiting Rhegmatogenous Retinal Detachment

Case Report

J Korean Ophthalmol Soc 2018;59(4):379-383.

Published online: 7 September 2018

DOI: https://doi.org/10.3341/jkos.2018.59.4.379

Two Cases of Outer Retinal Folds Developing after Vitrectomy in Patients Exhibiting Rhegmatogenous Retinal Detachment

Jung Hoo Lee, MD¹, Chang Ki Yoon, MD, PhD¹, Hyun Woong Kim, MD, PhD^2,

^¹Department of Ophthalmology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea

^²Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea

Address reprint requests to Hyun Woong Kim, MD, PhD Department of Ophthalmology, Inje University Haeundae Paik Hospital, #875 Haeun-daero, Haeundae-gu, Busan 48108, Korea Tel: 82-51-890-6114, Fax: 82-51-890-8722, E-mail: maekbak@hanmail.net

Received 17 August 2017 Revised 26 December 2017 Accepted 29 March 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We report two cases of retinal folds developing after pars plana vitrectomy in patients exhibiting rhegmatogenous retinal detachment.

Case summary

(Case 1) A healthy 52-year-old male visited our clinic complaining of blurred vision in his right eye. His visual acuity was 0.8 in that eye. Fundal examinations revealed upper retinal detachment and retinal tears at the 12 and 1 o'clock positions. He underwent pars plana vitrectomy with gas injection, and 1 week later, the retina was reattached. A retinal fold was detected at the 4 o'clock position; the fold extended for two disc diameters from the optic disc to the equator. The fold resolved spontaneously after 3 months. (Case 2) A 59-year-old male visited our clinic complaining of blurred vision in his right eye. His visual acuity was “counting fingers” in that eye. Fundal examination revealed a retinal tear at the 11 o'clock position and upper retinal detachment involving the macula. He underwent pars plana vitrectomy with gas injection. A retinal fold was detected in the temporal region of the disc running from the 7 o'clock position to the equator. Over 11 months of observation without treatment, optical coherence tomography (OCT) revealed that the retinal fold resolved.

Conclusions

We report the first two Korean cases of spontaneous relief of retinal folds developing after vitrectomy, and the OCT patterns of the folds.

Keywords: Optical coherence tomography, Pars plana vitrectomy, Retinal fold

REFERENCES

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Figure 1.

Fundus photography of case 1 before and after vitrectomy. (A) Upper retinal detachment was detected with retinal tear (at 12 and 1 o'clock) before vitrectomy. (B) Retinal fold was detected from the optic disc to the equator at 3 weeks after vitrectomy. (C) Retinal fold remained at 2 months after vitrectomy. (D) Retinal fold was relieved spontaneously after 3 months.

Figure 2.

Optical coherence tomography findings of case 1 at 3 months after vitrectomy. Retinal fold was not detected, but hyperreflective lesions were detected at inner retinal layer.

Figure 3.

Serial fundus photography of case 2 before and after vitrectomy. (A) Upper retinal detachment involving the macular was detected with retinal tear (at 11 o'clock) before vitrectomy. (B) Retinal fold was detected from mid periphery to the equator at 10 days after vitrectomy. (C) Retinal fold was partial relieved at 11 months after vitrectomy.

Figure 4.

Consecutive spectral-domain optical coherence tomography (OCT) findings of case 2 at 10 days after vitrectomy (A-C) and at 11 months after vitrectomy (D-F). (A) Infrared fundus image. Blue line: level of OCT cut. (B) Fundus image with cube scan overlay showed the range of retinal fold. (C) Raster scan. Retinal fold was detected through full thickness retinal layer with nerve fiber layer undulation and inner segment ellipsoid zone disruption at 10 days after vitrectomy. (D) Infrared fundus image. Blue line: level of OCT image. (E) Fundus image with cube scan overlay. The range of retinal folds was reduced in macular cube scan. (F) Retinal fold was relieved at 11 months after vitrectomy. Retinal fold's thickness was decreased and inner segment ellipsoid zone disruption was ameliorated in Raster scan image. The range of retinal folds was reduced in macular cube scan image.

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