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Polygonal Area of Retinal Pigment Epithelium Avulsion Following Retinal Cryotherapy for Retinal Detachment
Georgios Mylonas1, Gregor S Reiter1, Markus Ritter1
1Department of Ophthalmology, Medical University of Vienna, Vienna, Austria, meduniwien.ac.at.
Purpose:
This study is aimed at reporting a rare case of polygonal retinal pigment epithelium (RPE) avulsion following retinal cryotherapy for retinal detachment.
Methods:
Case report.
Results:
A 53-year-old man presented with recurrent retinal detachment 30 days after 23G vitrectomy with 20% sulfur hexafluoride (SF6) gas endotamponade. Intraocular pressure was < 1 mmHg, with horizontal chorioretinal folds due to hypotony. Re-vitrectomy with PFCL, cryotherapy, endolaser, and silicone oil was performed. During surgery, a large RPE avulsion with island formation and a small full-thickness retinal avulsion causing re-detachment were identified in the cryotherapy area. After 6 months with attached retina, the silicone oil was removed and the retina remained stable.
Conclusions:
Cryotherapy-induced scarring for retinal detachment repair is likely to cause traction. In our case, traction from the scar resulted in a full-thickness retinal tear and RPE avulsion, leading to re-detachment. Careful follow-up is essential to detect and treat complications.
Insights
Retinal cryotherapy for detachment can cause rare polygonal retinal pigment epithelium (RPE) avulsion due to scarring and traction. This case highlights the importance of monitoring for such complications after retinal detachment repair.
Area of Science:
- Ophthalmology
- Retinal Surgery
Background:
- Retinal detachment is a serious condition requiring surgical intervention.
- Cryotherapy is a common method used in retinal detachment repair.
Purpose of the Study:
- To report a rare case of polygonal retinal pigment epithelium (RPE) avulsion.
- To describe this complication following retinal cryotherapy for retinal detachment.
Main Methods:
- A case report detailing a 53-year-old male patient.
- Surgical intervention included vitrectomy, cryotherapy, endolaser, and silicone oil tamponade.
- Follow-up assessment over six months.
Main Results:
- The patient experienced recurrent retinal detachment post-vitrectomy.
- Intraoperative findings revealed a large RPE avulsion and a full-thickness retinal tear in the cryotherapy area.
- The retina remained stable after silicone oil removal at six months.
Conclusions:
- Cryotherapy-induced scarring can lead to traction, causing retinal tears and RPE avulsion.
- This case underscores the potential for tractional complications after cryotherapy.
- Vigilant follow-up is crucial for managing such rare complications.
