Abstract
Purpose :
To describe a recently discovered type of transient flat macular retinal detachment presenting early after intraocular surgery.
Methods :
Clinical examination and follow-up including SD-OCT and multimodal documentation of eyes with acute, transient, posterior retinal detachment.
Results :
APTRD was discovered in 5 eyes of 5 patients (age 41 to 87 years) on day 1 (4 cases) or day 2 after intraocular surgery. Previous surgical interventions were: Case 1: phacoemulsification with poster chamber lens implantation (PE&PCL), Case 2: PE&PCL 9 months after Pars plana-vitretomy (ppV) for rhegmatogenous retinal detachment (RRD), Case 3: PE&PCL combined with membrane peeling 10 months after ppV for RRD, Cases 4 & 5: ppV combined with sulcus-fixation of subluxated PCLs (both with pseudoexfoliation syndrome (PEX)). The shallow retinal detachment was localized within the major temporal vascular arcades (in case 1 extending into the extramacular und nasal fundus). In 2 eyes the fovea was completely detached (case 1 & 2). In all other cases the maximum height of RD was found close to the major vessel arcade in the inferior nasal macula. A close relation of RD to major or second order retinal vessel was obvious. In all cases the shallow RD rapidly resolved completely (until day 2 to 10 after surgery). Both eyes with foveal detachment improved to a visual acuity of 20/20. In 4 of 5 eyes (cases 1,2,3,5) regions of RD presented a transient anterior-posterior stretching of the Henle fibre layer. In case 1 postoperative vitreoretinal changes were detected, suggesting a direct tractional effect during surgery. In case 3 and 5 RD was associated with transient choroidal folds.
Conclusions :
To our knowledge, this type of transient shallow early postoperative retinal detachment with spontaneous resolution was so far not reported in literature. The etiology of this type of RD cannot completely be explained. There are indicators suggesting that either direct vitreoretinal traction and/or intraoperative pressure variations within the vitreous cavity may be responsible for the development of APTRD. Further evaluations are necessary to evaluate how frequently this clinical complication occurs, whether this kind of RD may be functionally relevant and how this complication can be avoided.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.