Pachychoroid as a Risk Factor for Exudative Retinal Detachment After Panretinal Photocoagulation: A Report of Two...

Area of Science:

• Ophthalmology
• Retinal Diseases
• Vascular Biology

Background:

• Pachychoroid is a condition characterized by choroidal thickening.
• Proliferative diabetic retinopathy (PDR) is a severe complication of diabetes affecting the retina.
• Panretinal photocoagulation (PRP) is a laser treatment used for PDR.

Observation:

• Two patients with PDR, serous pigment epithelial detachment (PED), and pachychoroid underwent PRP.
• Both patients developed exudative retinal detachment (RD) post-PRP, leading to visual loss.
• Exudative RD resolved in one patient with anti-inflammatory drops and spontaneously in the other within three weeks.

Findings:

• Pachychoroid, in conjunction with PDR, appears to be a risk factor for developing exudative RD after PRP.
• PRP-induced inflammation may overwhelm the compromised retinal pigment epithelium in the presence of choroidal thickening, leading to RD.
• Pre-procedure identification of pachychoroid is crucial for predicting this complication.

Implications:

• Clinicians should consider pachychoroid as a predictive factor for exudative RD post-PRP.
• This finding may guide treatment strategies and patient counseling for individuals with PDR and pachychoroid.
• Further research is warranted to elucidate the mechanisms and management of exudative RD in this context.