Spontaneous reattachment of rhegmatogenous retinal detachment as incidental finding

Author: Aida Jallouli (Tunisia)

Co-authors: Mona Rekik, Takwa Sammouda, Kmar Maaloul, Salma Gargouri, Amira Trigui

Purpose

To report a case of fortuitous discovery of spontaneous retinal reattachment and describe retinal findings as assessed by multimodal imaging

Setting/Venue

Department of Ophtalmplogy , Habib Bourguiba University Hospital , Faculty of medicine , University of sfax , Tunisia

Methods

Case report

Results

A 18-year-old man, with no medical history, presented with complaint of visual loss in the left eye one day following blunt ocular trauma. Best Visual acuities were limited to hand motion in the left eye and 10/10 in the right eye. The examination of the left eye revealed periocular hematoma ,subconjunctival hemorrhage and vitreous cells. Fundus examination showed granular changes in the macula; retinal pigment clumping, subretinal gliosis and snowflake degeneration of the peripherial retina. Fluorescein angiography showed choroidal filling defect in early phase and increasing heterogeneous fluorescence along the sequence by window defect.Optical coherence tomography revealed retinal atrophy predominant on outer retinal layers and subretinal hyperreflective spots corresponding to gliosis. The diagnosis of presumed spontaneous reattachment of rhegmatogenous retinal detachment (SRRRD) was rendered on the basis of funduscopic and mulitimodal imaging findings

Conlusions

Spontaneous retinal reattachment is uncommon in natural evolution of rhegmatogenous retinal detachment and it is often undervalued. The diagnosis of SRRRD was often carried out retrospectively on the basis of suggestive signs on fundus examination. It is more likely observed in myopic eye and in case of inferior retinal detachment Various controversial mechanisms have been proposed including: 1) The spontaneous sealing of a retinal break consequent to the relief of tangential traction (release of preretinal proliferation ) . 2)The presence of solid vitreous occluding the retinal hole . 3)Posterior vireous detachment described in victrectomized eye. SRRRD should be distinguished from other conditions in which similar features of the fundus are observed like resolved status of posterior uveitis ;chronic central serous choroidopathy; trauma related conditions and dystrophic retinal disorders. Trauma was a circumstance of discovery of asymptomatic SRRRD in our case which was not reported in the literature till now.

Financial Disclosure

no financial disclosure

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