{"title":"Spontaneous Retinal Reattachment following Multiple Vitreoretinal Interventions: Case Report.","authors":"Nathan Nash Wise, Eric K Chin, David R P Almeida","doi":"10.1159/000540346","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to document and analyze a rare case of spontaneous retinal reattachment in a patient after successive unsuccessful vitreoretinal surgeries and to explore potential mechanisms contributing to this unexpected outcome.</p><p><strong>Case presentation: </strong>A 61-year-old patient with a history of high myopia presented with a rhegmatogenous retinal detachment. After undergoing multiple vitreoretinal procedures, including pars plana vitrectomy with silicone oil tamponade, anatomical reattachment was not achieved, and the patient developed complex retinal detachment associated with myopic foveoschisis. Surprisingly, spontaneous reattachment of the retina was observed during routine follow-up. Comprehensive ocular examination, optical coherence tomography (OCT), and fundus autofluorescence imaging were utilized to confirm and document the retinal status. A thorough review of patient history, surgical reports, and postoperative imaging was performed to discern potential contributory factors. The patient's retina remained attached for 12 months after the last intervention without additional surgical or medical treatment. OCT images revealed normalization of retinal architecture with reestablishment of the foveal contour and partial recovery of visual acuity. No signs of proliferative vitreoretinopathy or other commonly associated complications were observed. Immunological assays and genetic testing ruled out systemic conditions that could predispose to spontaneous reattachment.</p><p><strong>Conclusion: </strong>This case represents a remarkable instance of spontaneous retinal reattachment without surgical intervention after multiple failed procedures. The mechanisms underlying this phenomenon remain speculative; however, they may involve delayed postoperative cellular proliferation and migration, subtle intraocular pressure changes, or unrecognized vitreous traction resolution. Further investigation into similar cases may provide insights into the natural history of retinal detachment and potential self-resolving dynamics, which could inform future therapeutic strategies.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.5000,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521428/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Case Reports in Ophthalmology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1159/000540346","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
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Abstract
Introduction: The aim of the study was to document and analyze a rare case of spontaneous retinal reattachment in a patient after successive unsuccessful vitreoretinal surgeries and to explore potential mechanisms contributing to this unexpected outcome.
Case presentation: A 61-year-old patient with a history of high myopia presented with a rhegmatogenous retinal detachment. After undergoing multiple vitreoretinal procedures, including pars plana vitrectomy with silicone oil tamponade, anatomical reattachment was not achieved, and the patient developed complex retinal detachment associated with myopic foveoschisis. Surprisingly, spontaneous reattachment of the retina was observed during routine follow-up. Comprehensive ocular examination, optical coherence tomography (OCT), and fundus autofluorescence imaging were utilized to confirm and document the retinal status. A thorough review of patient history, surgical reports, and postoperative imaging was performed to discern potential contributory factors. The patient's retina remained attached for 12 months after the last intervention without additional surgical or medical treatment. OCT images revealed normalization of retinal architecture with reestablishment of the foveal contour and partial recovery of visual acuity. No signs of proliferative vitreoretinopathy or other commonly associated complications were observed. Immunological assays and genetic testing ruled out systemic conditions that could predispose to spontaneous reattachment.
Conclusion: This case represents a remarkable instance of spontaneous retinal reattachment without surgical intervention after multiple failed procedures. The mechanisms underlying this phenomenon remain speculative; however, they may involve delayed postoperative cellular proliferation and migration, subtle intraocular pressure changes, or unrecognized vitreous traction resolution. Further investigation into similar cases may provide insights into the natural history of retinal detachment and potential self-resolving dynamics, which could inform future therapeutic strategies.
期刊介绍：
This peer-reviewed online-only journal publishes original case reports covering the entire spectrum of ophthalmology, including prevention, diagnosis, treatment, toxicities of therapy, supportive care, quality-of-life, and survivorship issues. The submission of negative results is strongly encouraged. The journal will also accept case reports dealing with the use of novel technologies, both in the arena of diagnosis and treatment. Supplementary material is welcomed. The intent of the journal is to provide clinicians and researchers with a tool to disseminate their personal experiences to a wider public as well as to review interesting cases encountered by colleagues all over the world. Universally used terms can be searched across the entire growing collection of case reports, further facilitating the retrieval of specific information. Following the open access principle, the entire contents can be retrieved at no charge, guaranteeing easy access to this valuable source of anecdotal information at all times.
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