Retinal Vessel Printings on Fundus Autofluorescence Imaging Represent Retinal Displacement: Proof of Prior Hypothesis

• Published in: American journal of ophthalmology Vol. 238; pp. e3 - e4
• Main Authors: Brosh, Koby, Roditi, Eduardo, Muni, Rajeev H.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-06-2022; Elsevier Limited
• Subjects: Case reports; Fluorescein Angiography - methods; Fundus Oculi; Humans; Medical diagnosis; Medical imaging; Optic nerve; Optical Imaging; Printing, Three-Dimensional; Retina; Retinal detachment; Retinal Vessels - diagnostic imaging
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2022.01.024

A 68-year-old male presented with a macula-off rhegmatogenous retinal detachment (RRD) in the right eye that was treated with pars plana vitrectomy (PPV). Shiragami hypothesized that RVPs commonly occur after PPV and represent retinal displacement.1 RVP's are thought to occur because of differences in the composition and characteristics of the fluorophores in the RPE cells or differences in the metabolic activity of RPE cells that are naïve to light exposure.1,2 Retinal displacement is thought to occur because of a stretch of the retina that occurs because of the movement of residual subretinal fluid at the completion of surgery (often inferiorly), induced by the buoyant force of the tamponade in a direction related to head position and gravity.3,4 This case, for the first time proves that RVPs are in fact aligned with the prior location of retinal vessels before the retinal detachment occurred as hypothesized by Shiragami. There is increasing evidence to support that the integrity of anatomic outcomes following retinal detachment can vary with surgical technique and this may impact functional outcomes.4 This case highlights how extensive retinal displacement can be, even in cases with subtle post-operative RVPs and suggests that patients may benefit from surgical techniques that are refined to minimize the risk of LIRA.