Itaru Kimura1,2, Kei Shinoda3,4, Tadahiko Eshita3, Makoto Inoue3, Yukihiko Mashima3. 1. Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan. kimura@sc.itc.keio.ac.jp. 2. Laboratory of Clinical Epidemiology, National Institute of Sensory Organs, Tokyo, Japan. kimura@sc.itc.keio.ac.jp. 3. Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan. 4. Laboratory of Visual Physiology, National Institute of Sensory Organs, Tokyo, Japan.
Abstract
BACKGROUND: We report a patient with a visual field defect after retinal reattachment by the encircling procedure for rhegmatogenous retinal detachment. We confirmed improved ocular blood flow after relaxation of the buckle. CASE: A 24-year-old woman with a visual field defect appearing after an encircling procedure for rhegmatogenous retinal detachment. OBSERVATIONS: Before and after relaxing the encircling buckle, we measured tissue blood flow in the fundus of each eye of the patient using a Heidelberg retina flow meter. Preoperative measurements showed a reduction of blood flow at the disc rim in the diseased fundus, while retinal blood flow was not reduced (P = 0.026, disc rim area versus retinal area, one-factor analysis of variance, ANOVA). Indocyanine green angiography showed extensive peripheral filling delay. Electroretinography showed low a-wave and b-wave amplitudes, but normal oscillatory potential. The base value of the electro-oculogram was severely reduced in the right eye. The blood flow values after surgery indicated a significant improvement of blood flow (P = 0.01, one-factor ANOVA). No further progression in the visual field defect was observed, and visual acuity of the right eye improved from 0.8 to more than 1.0. CONCLUSIONS: These results suggest that the choroidal circulation disturbance, which was found after the encircling procedure, had a plausible role in the development of the visual field defect.
BACKGROUND: We report a patient with a visual field defect after retinal reattachment by the encircling procedure for rhegmatogenous retinal detachment. We confirmed improved ocular blood flow after relaxation of the buckle. CASE: A 24-year-old woman with a visual field defect appearing after an encircling procedure for rhegmatogenous retinal detachment. OBSERVATIONS: Before and after relaxing the encircling buckle, we measured tissue blood flow in the fundus of each eye of the patient using a Heidelberg retina flow meter. Preoperative measurements showed a reduction of blood flow at the disc rim in the diseased fundus, while retinal blood flow was not reduced (P = 0.026, disc rim area versus retinal area, one-factor analysis of variance, ANOVA). Indocyanine green angiography showed extensive peripheral filling delay. Electroretinography showed low a-wave and b-wave amplitudes, but normal oscillatory potential. The base value of the electro-oculogram was severely reduced in the right eye. The blood flow values after surgery indicated a significant improvement of blood flow (P = 0.01, one-factor ANOVA). No further progression in the visual field defect was observed, and visual acuity of the right eye improved from 0.8 to more than 1.0. CONCLUSIONS: These results suggest that the choroidal circulation disturbance, which was found after the encircling procedure, had a plausible role in the development of the visual field defect.
Authors: Dominik Odrobina; Iwona Laudańska-Olszewska; Piotr Gozdek; Mariusz Maroszyński; Michael Amon Journal: Biomed Res Int Date: 2013-06-11 Impact factor: 3.411