Bullous Exudative Retinal Detachment after Retinal Pattern Scan Laser Photocoagulation in Diabetic Retinopathy

NOVEL OPTICAL COHERENCE TOMOGRAPHY FINDINGS IN SEROUS MACULAR DETACHMENT AFTER PANRETINAL PHOTOCOAGULATION

PURPOSE

To describe a novel optical coherence tomography finding in a case of macular serous retinal detachment after pars plana vitrectomy and panretinal photocoagulation.

METHODS

Retrospective case report.

RESULTS

A 52 year old male with diabetes underwent uncomplicated pars plana vitrectomy with panretinal photocoagulation for non-clearing vitreous hemorrhage, Postoperative course was complicated by significantly decreased vision and a macular serous retinal detachment that was characterized on optical coherence tomography by a reticular network of hyperreflective bands in the subretinal space. Fluid and hyperreflective material in the subretinal space resolved by postoperative Week 6 with standard postoperative eye drops. However, persistent ellipsoid zone disruption was seen up to postoperative Week 20.

CONCLUSION

Extensive subretinal bands can be seen after panretinal photocoagulation. This novel finding can pose diagnostic and management challenges but may resolve with conservative medical management.

IGF-1, Inflammation and Retinal Degeneration: A Close Network

Retinal degenerative diseases are a group of heterogeneous diseases that include age-related macular degeneration (AMD), retinitis pigmentosa (RP), and diabetic retinopathy (DR). The progressive degeneration of the retinal neurons results in a severe deterioration of the visual function. Neuroinflammation is an early hallmark of many neurodegenerative disorders of the retina including AMD, RP and DR. Microglial cells, key components of the retinal immune defense system, are activated in retinal degenerative diseases. In the microglia the interplay between the proinflammatory/classically activated or antiinflammatory/alternatively activated phenotypes is a complex dynamic process that occurs during the course of disease due to the different environmental signals related to pathophysiological conditions. In this regard, an adequate transition from the proinflammatory to the anti-inflammatory response is necessary to counteract retinal neurodegeneration and its subsequent damage that leads to the loss of visual function. Insulin like-growth factor-1 (IGF-1) has been considered as a pleiotropic factor in the retina under health or disease conditions and several effects of IGF-1 in retinal immune modulation have been described. In this review, we provide recent insights of inflammation as a common feature of retinal diseases (AMD, RP and RD) highlighting the role of microglia, exosomes and IGF-1 in this process.