|Year : 2022 | Volume
| Issue : 4 | Page : 994
Accidental total retinectomy
Bruttendu Moharana, Bhumija Bhatt, Sucheta Parija
Department of Ophthalmology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
|Date of Submission||20-May-2022|
|Date of Acceptance||28-Jul-2022|
|Date of Web Publication||11-Oct-2022|
Dr. Bruttendu Moharana
Assistant Professor, Department of Ophthalmology, All India Institute of Medical Sciences, Bhubaneswar, Odisha
Source of Support: None, Conflict of Interest: None
Keywords: Accidental retinectomy, bare choroid, vitreous hemorrhage
|How to cite this article:|
Moharana B, Bhatt B, Parija S. Accidental total retinectomy. Indian J Ophthalmol Case Rep 2022;2:994
A 42-year-old gentleman presented with complaints of vision loss in the right eye (RE) for a duration of 2 months. Treatment history revealed that he had received bilateral pan-retinal photocoagulation (PRP) for proliferative diabetic retinopathy (PDR) 6 months ago. Two months ago, he developed vitreous hemorrhage in the RE for which he underwent vitrectomy and silicone oil tamponade elsewhere. Visual acuity (VA) in the RE worsened after the surgery. On examination, VA was light perception with inaccurate projection of rays in the RE (preoperative VA was counting fingers) and 20/40 in the left eye (LE). RE fundus examination showed silicone oil-filled globe. Bare choroid was seen without identifiable retinal tissue or retinal blood vessels [Figure 1]a. A grayish structure was seen with spots of hemorrhage and frills of translucent membranes covering it [[Figure 1]a and [Figure 1]b, arrow]. Due to its presence at the anatomical location of the disc, we concluded that it is the optic disc with retinal frills covering it. Laser scars from PRP were seen nasally [[Figure 1]b, arrowhead]. No retinal structure was identifiable on optical coherence tomography [Figure 1]c. LE showed lasered PDR with vitreous hemorrhage [Figure 1]d.
|Figure 1: The bare choroid is visible without any identifiable retinal structure or retinal blood vessels (a). The optic disc is covered with a frill of the retinal remnant (arrow) (a and b). Laser scars from previous pan-retinal photocoagulation (PRP) were seen nasally (arrow-head) (b). Optical coherence tomography of the right eye shows only retinal pigment epithelium (white arrow) and choroid (red arrow) without any retinal tissue (c). The left eye fundus shows proliferative diabetic retinopathy with PRP scars and vitreous hemorrhage (d). Black stars show flash-induced artefacts (b and d)|
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| Discussion|| |
Total retinectomy is done in cases of advanced proliferative vitreoretinopathy (penetrating trauma, Coat's disease, persistent fetal vasculature), which are not amenable to vitreoretinal surgical procedures. This prevents the development of iris neovascularization and phthisis bulbi. The retinectomy, in this case, was perhaps done inadvertently while performing vitrectomy for dense diabetic vitreous hemorrhage. Such serious complications can be prevented by a meticulous preoperative ultrasound B scan to detect the presence of tractional retinal detachment in the presence of dense vitreous hemorrhage. Hemorrhages should be cleared layer by layer ensuring that there is no accidental retinal damage. Vitrectomy should be done cautiously in the nasal area so that any inadvertent retinal damage will have minimal impact on VA.
Declaration of patient consent
The authors ctxertify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
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Conflicts of interest
There are no conflicts of interest.
| References|| |
Karacorlu M, Sayman Muslubas I, Hocaoglu M, Arf S, Ersoz MG. Long-term results of total retinectomy in cases with advanced proliferative vitreoretinopathy. Retina 2017;37:1529-34.