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Persistent subretinal fluid mimicking central serous retinopathy after scleral buckling surgery: possible vortex vein compression role

Abstract

Purpose

To describe the case of a woman who developed persistent subretinal fluid in the macular region after the placement of encircling band for retinal detachment surgery, possibly due to vortex vein compression.

Methods

Case report.

Results

A 66-year-old woman diagnosed with central serous retinopathy presented with poor vision and metamorphopsia in the left eye (LE). Her visual acuity had deteriorated to 20/100 in LE after retinal detachment surgery with scleral buckling 8 months before. Multimodal imaging including fundus autofluorescence and fluorescein angiography disclosed a gravitational hyperfluorescent area involving the macular region that appeared to originate from the superotemporal quadrant in correspondence with the buckling. This area corresponded to a serous retinal detachment on structural spectral-domain optical coherence tomography (SD-OCT). Interestingly, on indocyanine green angiography, the encircling band of the scleral buckling appeared located at the emergence of the superotemporal vortex vein. Based on these findings, the patient was diagnosed with gravitational serous retinal detachment secondary to vortex vein compression. Successful rapid visual recovery and decrease of retinal fluid on SD-OCT was achieved with prompt surgery of scleral buckling removal, confirming the diagnosis.

Conclusions

Choroidal veins can be obliterated during retinal detachment surgery, especially when retinal breaks are posterior to the equator. Indocyanine green angiography is the gold standard to study choroidal circulation and in our case allowed us to visualize the compression of the superotemporal vortex vein at the site of scleral buckling.

Eur J Ophthalmol 2017; 27(2): e54 - e56

Article Type: CASE REPORT

DOI:10.5301/ejo.5000876

Authors

Chiara Giuffrè, Adriano Carnevali, Marco Codenotti, Eleonora Corbelli, Luigi A. De Vitis, Lea Querques, Francesco Bandello, Giuseppe Querques

Article History

Disclosures

Financial support: F. Bandello: advisory board member: Allergan, Inc.; Novartis Pharmaceuticals Corporation; Farmila-Thea; Bayer Schering Pharma; Pfizer, Inc.; Alcon, Inc.; Bausch and Lomb; Genentech, Inc.; Alimera Sciences, Inc.; Thrombogenics, Inc.
Conflict of interest: None of the authors has conflict of interest with this submission.

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Authors

Affiliations

  •  Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute, Milan - Italy
  •  Department of Ophthalmology, University of “Magna Graecia”, Catanzaro - Italy

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