Título

HYPERAUTOFLUORESCENT VERMIFORM IMAGE IN THE MACULA AFTER VITRECTOMY: A CURIOUS FINDING

Objetivo

Describe the finding of a vermiform image in the macular region of a patient who underwent vitrectomy for the treatment of retinal detachment

Métodos

Case report

Resultados

60-year-old female patient was referred for specialized evaluation due to retinal detachment in the left eye (OS). She reported a history of cataract surgery in both eyes, past infectious uveitis in the OS. She was submitted to laser treatment for retinal detachment performed 2 years ago followed by surgery for retinal detachment 1 year later.
On ophthalmologic examination, right eye was normal. In the OS, she had vision equivalent to counting fingers, biomicroscopy and tonometry without significant findings, and retinal mapping revealed inferior retinal detachment affecting the macula, in addition to peripheral scars of temporal laser, adjacent to the area of ​​applied retina. The rupture was identified in the middle periphery, adjacent to the described laser area. Posterior vitrectomy was performed and silicone oil was used as a temporary vitreous temponading agent. Postoperative recovery was satisfactory, with anatomical improvement and maintenance of visual acuity.
In the third week after surgery, a multimodal evaluation of the retina was performed, with Retinography, Autofluorescence and Optical Coherence Tomography. An atypical lesion was identified in the macula region.
Three months after surgery, the ophthalmologic examination of the left eye remained unchanged.
The multimodal evaluation of the retina was repeated, and the same pattern of images was identified.

Discussão e Conclusões

The exams performed allowed us to determine that the hyperautofluorescent lesion is found on the surface and inner layers of the retina and presents a hyperreflective finding on SD-OCT. No similar report was found in the literature. Among the suspicions considered for the origin of the lesion include: nematode, an exam artifact or a foreign body (cotton, gauze or suture thread fragment).

Palavras Chave

VERMIFORM, VITRECTOMY, MULTIMODAL

Área

Cirúrgica