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Case 69

Contributor: Shaan Bhambra MD, Wei Wei Lee MD FRCSC

Patient Presentation: A 62-year old male presented to the emergency room after experiencing flashes and floaters for a week OD. He denied past medical or ocular history, though he did note a glasses prescription of -5.50D OU.  His vision was 20/200 OD and 20/25 OS. IOP was 11 OD and 14 OS; there was no RAPD. Anterior segment examination was within normal limits, though the vitreous was Shafer's sign positive OD. Fundus examination demonstrated a macula-off rhegmatogenous retinal detachment (RRD) extending from 11 to 3 o'clock with a single retinal tear at 12 o'clock OD. 

Question 1: What is the preferred treatment method for a superior rhegmatogenous retinal detachment (RRD) with all breaks able to be visualized?

The patient returned to clinic 1 month following his PnR. He denied any flashes or field defect, but did note a few persistent floaters OD. His vision was 20/30 OD. An en face OCT was conducted and shown below:


Question 2: What are the red arrows in the above en face OCT demonstrating?

Question 3: Which RRD repair method is more highly correlated with the development of ORFs?

Question 4: How are ORFs associated to post-operative visual acuity?

Learning Objectives:

  1. Understand how to diagnose ORFs on OCT imaging.

  2. The significance and prevalence of ORFs after RRD surgery.

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