Letter to the Editor

Crystalline Maculopathy Secondary to Retinal Tear Without Detachment

Purpose:

Crystalline maculopathy secondary to chronic retinal detachment (RD) has previously been described. This article proposes a novel mechanism to explain crystalline formation in the absence of RD.

Methods:

Two patients, who were referred for routine examination, were found to have a crystalline maculopathy in the setting of an asymptomatic, chronic-appearing, peripheral retinal tear. Fundoscopy and optical coherence tomography were used to assess the crystals and tear. No specimens were obtained.

Results:

We describe 2 cases of a crystalline maculopathy secondary to an asymptomatic peripheral retinal tear. We hypothesized macrophage ingestion of photoreceptor segments emanating from the tear may have contributed to macular crystalline deposition.

Conclusions:

Because crystalline maculopathy can present in the setting of RD, there may be a shared pathogenesis between the 2 conditions.

LOCALIZATION OF MACULAR CRYSTALS ASSOCIATED WITH CHRONIC RETINAL DETACHMENT TO THE POSTERIOR HYALOID USING SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY

PURPOSE

To present a case of crystalline retinopathy associated with chronic retinal detachment and localize the macular crystals using spectral domain optical coherence tomography.

METHODS

Case Report.

RESULTS

A 37-year-old man with previously treated chronic retinal detachment presented with normal vision and crystalline maculopathy. Spectral domain optical coherence tomography localized the macular crystals to the posterior hyaloid membrane and on the internal limiting membrane, but not within the retina.

CONCLUSION

The macular crystals in crystalline retinopathy associated with chronic retinal detachment most likely originate in the subretinal space beneath the detached retina, migrate through the retinal break into the vitreous cavity, and lodge on the surface of the internal limiting membrane. When the posterior hyaloid membrane separates, the crystals, which are attached to the posterior hyaloid membrane, elevate from the retina.

Refractile superficial retinal crystals and chronic retinal detachment: case report

Background

Few previous reports have described the presence of retinal refractile opacities at the macular area in patients presenting with longstanding peripheral retinal detachment. The exact nature of these opacities is unknown.

Case presentation

Two patients were referred with an abnormal appearance of refractile opacities in the macular area noted during routine examination. Both were found to have longstanding peripheral retinal detachments. Subretinal fluid analysis of one patient revealed the presence of multiple birefringent crystals. We hypothesise that these crystals are the origin of the refractile macular opacities noted.

Conclusion

This report describes the rare presentation of asymptomatic peripheral retinal detachment by the detection of refractile macular opacities on routine examination. It highlights the importance of meticulous peripheral retinal examination in these cases. The article also describes the findings of the subretinal fluid analysis and discusses the possible hypothesis behind their appearance.