Title

HYPERAUTOFLUORESCENT VERMIFORM IMAGE IN THE MACULA AFTER VITRECTOMY

Introduction

Surgical management of rhegmatogenic primary retinal detachment has changed dramatically over the years, and incremental improvements in retinal detachment repair have led to progressively higher success rates. The use of silicone oil in vitreoretinal surgery was introduced in 1962 and is used as a temporary vitreous substitute in complex cases of retinal detachment.

Methods

A case report with medical record review.

Results

60 yo female, referred for specialized evaluation due to retinal detachment in the left eye (LE). She was pseudophakic in both eyes, and in LE she had a history of infectious uveitis and laser treatment for retinal detachment performed 2 years ago and surgery for retinal detachment performed 1 year ago. Retinal mapping revealed detachment of the lower retina, affecting the macula, in addition to peripheral scars from the temporal laser, adjacent to the applied retinal area. The rupture was identified in the middle periphery. Posterior vitrectomy was performed and silicone oil was used as a temporary vitreous substitute. The postoperative recovery was satisfactory, with anatomical improvement and maintenance of visual acuity. Three weeks after surgery, multimodal retinal evaluation was performed, with retinography, autofluorescence and SD-OCT. An atypical lesion was identified in the macula region. Three months after surgery, the ophthalmic examination of the left eye remained unchanged.

Discussion

The tests carried out made it possible to determine that the hyper-autofluorescent lesion is found on the surface and internal layers of the retina, and has a hyper-reflective character in the SD-OCT. No similar report has been found in the literature. The hypotesis for the origin of the lesion are nematodes, artifacts and foreign bodies (cotton, gauze or suture fragment), however, it was not possible to determine the exact cause of the image. It remains as an unknown finding in a a routine case that was wasn’t justified by other reasons.

Keywords

Retinal detachment; unknown; vitrectomy;

Area

SURGICAL CASE

Authors

Rafael Cicconi Arantes, Lana Martins Menezes, Juliana Abreu Rio, Ricardo Luz Leitão Guerra