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MACULAR BUCKLING WITH ANDO PLOMBE MAY INCREASE CHOROIDAL THICKNESS AND MIMIC SEROUS RETINAL DETACHMENT SEEN IN THE TILTED DISK SYNDROME

Mateo, Carlos, MD; Burés-Jelstrup, Anniken, MD

Retinal Cases and Brief Reports: October 2016 - Volume 10 - Issue 4 - p 327–330
doi: 10.1097/ICB.0000000000000261
Case Report
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Purpose: Serous subfoveal detachment has been described in the literature as a complication that appears at the border of the staphyloma. Macular buckling induces a postoperative inward bulge that resembles the ridge of a staphyloma. We describe three patients who developed a serous subfoveal detachment after uneventful macular buckling. To our knowledge, this complication, that shares similarities with the staphyloma ridge detachment, has not been previously reported.

Methods: The clinical records of all cases that underwent macular buckling at our clinic were reviewed.

Results: Three patients developed a serous subfoveal detachment that could not be explained by choroidal neovascularization or polypoidal vascular choroidopathy. Along with the development of the subfoveal detachment, we observed an increase of the choroidal thickness beneath the fovea. This thickening, that tended to progress during the follow-up, resolved spontaneously after explantation of the buckle. The decrease in foveal thickness did also lead to resolution of the subfoveal detachment.

Conclusion: The development of the subfoveal detachment in our patients was closely associated with a focal increase of the choroidal thickness after the macular buckling. After the buckle was removed, the choroidal thickness went back to the normal prebuckling values and the detachment resolved in all three patients. This leads us to think that there is a close association between choroidal thickness and the serous subfoveal detachment.

Uncomplicated macular buckling for the treatment of tractional myopic maculopathy may lead to a subfoveal detachment that develops in the absence of other contributive factors. The authors’ observations have led them to conclude that there is a link between the subretinal fluid and an increased choroidal thickness, triggered by the surgical procedure.

Instituto de Microcirugía Ocular, Barcelona, Spain.

Reprint requests: Carlos Mateo, MD, Instituto de Microcirugía Ocular, C. Josep Maria LLadó 3 (salida 7 Ronda de Dalt), 08035 Barcelona, Spain; e-mail: carlosmateo@me.com

None of the authors have any financial/conflicting interests to disclose.

© 2016 by Ophthalmic Communications Society, Inc.