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| PHOTO ESSAY |
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| Year : 2023 | Volume
: 3
| Issue : 2 | Page : 582-583 |
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Laser retinopexy in a combined case of choroidal detachment and rhegmatogenous retinal detachment
Manpreet Brar, Mangat Ram Dogra, Satinder Pal Singh Grewal
Department of Retina, Grewal Eye Institute, Chandigarh, India
| Date of Submission | 15-Dec-2022 |
| Date of Acceptance | 24-Feb-2023 |
| Date of Web Publication | 28-Apr-2023 |
Correspondence Address:
Mangat Ram Dogra
Director Retina Service, Grewal Eye Institute, Chandigarh
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/IJO.IJO_3268_22
Keywords: Choroidal detachment, laser retinopexy, retinal detachment
How to cite this article:
Brar M, Dogra MR, Grewal SP. Laser retinopexy in a combined case of choroidal detachment and rhegmatogenous retinal detachment. Indian J Ophthalmol Case Rep 2023;3:582-3 |
How to cite this URL:
Brar M, Dogra MR, Grewal SP. Laser retinopexy in a combined case of choroidal detachment and rhegmatogenous retinal detachment. Indian J Ophthalmol Case Rep [serial online] 2023 [cited 2023 Jun 10];3:582-3. Available from: https://www.ijoreports.in/text.asp?2023/3/2/582/375033 |
A 78-year-old male presented with complaints of sudden onset floaters and flashes in his left eye for 5 days. The right eye had a poor vision due to an old branch retinal vein occlusion. BCVA in his right eye was CF-2m and in his left eye was 6/9 P.
Color fundus photographs of the left eye showed nasal and temporal dome-shaped dark shadows arising from choroidal detachment (CD) and inferior retinal elevation due to retinal detachment (RD); retinal break at 6 o'clock and macula was on [Figure 1]a. He was started on oral corticosteroids at the dose of 1 mg/kg body weight and a laser barrage was initiated for the localized inferior RD [Figure 1]b. After two weeks, color fundus montage showed regression of the nasal and temporal choroidal detachment and the inferior retina appears flat [Figure 1]c. His last follow-up was at 4 months after his initial presentation. The visual activity was maintained at 6/9. Choroidal detachment has disappeared and the retina is attached 360 with laser photocoagulation scars seen in the inferior peripheral retina [Figure 1]d. | Figure 1: (a) Color fundus montage image of a 65-year-old male with combined choroidal detachment (nasal and temporal) and inferior retinal detachment with a retinal break inferiorly. (b) Color fundus montage image immediately after laser photocoagulation. (c) Color fundus montage 2 weeks after laser and oral corticosteroids demonstrates partial resolution of choroidal detachments and RD has settled. (d) Color fundus montage image 4 months after treatment shows complete resolution of CD with attached retina 360 degrees
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| Discussion | |  |
Primary rhegmatogenous retinal detachment associated with preoperative choroidal detachment is rarely reported in 2.0–4.5% of cases.[1] Treatment options have been mainly surgical that includes primary pars plana vitrectomy (PPV) or scleral buckling. Scleral buckle has been associated with poor anatomic success in patients with preoperative CD.[2] PPV with or without preoperative oral corticosteroids remains the procedure of choice for such cases.[3] Nonsurgical methods of pneumatic retinopexy have also been rarely reported in the literature.[4] However, to the best of our knowledge, our case has been unusual as laser photocoagulation to seal the retinal breaks along with oral corticosteroids has resulted in a successful anatomical outcome. It demonstrates the feasibility of nonsurgical laser treatment in selected cases of combined CD/RD with inferior breaks.
Combined retinal detachment and choroidal detachment is an uncommon diagnosis and PPV surgery remains challenging in such cases, less experienced vitreoretinal surgeons will face a few difficulties during certain steps. Our case highlights the advantage of an outpatient-based nonsurgical retinal laser procedure that has a successful anatomical outcome and intraoperative and postoperative risks associated with vitrectomy surgery have been avoided with preservation of vision in his good eye.
Declaration of patient consent
The authors certify 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 initial s will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Gottlieb F. Combined choroidal and retinal detachment. Arch Ophthalmol 1972;88:481–6.  |
| 2. | Sharma T, Challa JK, Ravishankar KV, Murugesan R. Scleral buckling for retinal detachment. Predictors for anatomic failure. Retina 1994;14:338–43. |
| 3. | Sharma T, Gopal L, Reddy RK, Kasinathan N, Shah NA, Sulochana KN, et al. Primary vitrectomy for combined rhegmatogenous retinal detachment and choroidal detachment with or without oral corticosteroids: A pilot study. Retina 2005;25:152–7. |
| 4. | Yeung L, Kokame GT, Brod RD, Lightman DA, Lai JC. Pneumatic retinopexy for retinal detachment associated with severe choroidal detachment. Retina 2011;31:87–92. |
[Figure 1]
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