Ophthalmic Surgery, Lasers and Imaging Retina

Imaging Case Report 

The Role of Diagnostic Imaging Techniques in the Management of Retinal Detachment Due to Macular Hole in High Myopia

Paolo Carpineto, MD; Agbeanda Aharrh-Gnama, MD; Luca Di Antonio, MD; Mario Nubile, MD; Guido Di Marzio, MD; Leonardo Mastropasqua, MD

Abstract

ABSTRACT

After preoperative assessment revealed anomalous posterior vitreous detachment, a 75-year-old woman affected with retinal detachment due to macular hole was scheduled to undergo the posterior episcleral buckling procedure. Preoperative microperimetry showed unstable eccentric fixation with a dense scotoma within the central 8°. One month postoperatively, best-corrected visual acuity increased from 1.70 to 0.88 logarithm of the minimum angle of resolution. Ultrasonography and optical coherence tomography revealed the indentation of the posterior scleral profile due to the buckle. The retina appeared fully attached and a macular hole with flattened edges was still detectable. Microperimetry showed stable central fixation with recovery of retinal sensitivity within the central 2°. Diagnostic imaging techniques guided the decision to use the posterior episcleral buckling procedure. Microperimetry was useful to explain vision improvement despite residual macular hole. [Ophthalmic Surg Lasers Imaging 2009;40:602-606.]

Abstract

ABSTRACT

After preoperative assessment revealed anomalous posterior vitreous detachment, a 75-year-old woman affected with retinal detachment due to macular hole was scheduled to undergo the posterior episcleral buckling procedure. Preoperative microperimetry showed unstable eccentric fixation with a dense scotoma within the central 8°. One month postoperatively, best-corrected visual acuity increased from 1.70 to 0.88 logarithm of the minimum angle of resolution. Ultrasonography and optical coherence tomography revealed the indentation of the posterior scleral profile due to the buckle. The retina appeared fully attached and a macular hole with flattened edges was still detectable. Microperimetry showed stable central fixation with recovery of retinal sensitivity within the central 2°. Diagnostic imaging techniques guided the decision to use the posterior episcleral buckling procedure. Microperimetry was useful to explain vision improvement despite residual macular hole. [Ophthalmic Surg Lasers Imaging 2009;40:602-606.]

Authors

From the Department of Medicine and Aging Sciences, Section of Ophthalmology, University “G. d’Annunzio,” Chieti-Pescara, Italy.

Accepted for publication October 14, 2008.

The authors have no financial or proprietary interest in the materials presented herein.

Address correspondence to Paolo Carpineto, MD, University “G. d’Annunzio,” Department of Medicine and Aging Sciences, Section of Ophthalmology, Clinic Hospital Colle dell’Ara, via dei Vestini, 66013 Chieti, Italy.

10.3928/15428877-20091030-14

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