Discussion
Rhegmatogenous RD affects approximately about 1 in 10000 of the
population annually. Both eyes can be affected in about 10% of cases.
It’s uncommon in children, ranging from 3% to 12% of all patients
suffering from rhegmatogenous RD. (4). Tolentino FI et al preliminary’s
study on 5 patients with rhegmatogenous RD reported the presence of
leakage in FFA secondary to rhegmatogenous RD. The dye leakage was
observed in longstanding RDs (months). In addition, persistent leakage
of fluorescein from the capillaries of the optic disc and posterior pole
retinal vessels several months after reattachment surgery was noted.
(5). They also reported leakage in FFA along the edge of retinal tears.
Their size varied, but most were one disc in diameter or larger.
Subclinical RD around the tear was present in most of the cases. (5).
Although our case may be considered as a simple association between the
rhegmatogenous retinal detachment and fluorescence leakage, we want to
focus on the importance of being highly suspicious when no
rhegmatogenous element is detected, and doing fundus exam with
indentation and contact lens. Despite the presence of pigmented cells in
the anterior vitreous in our patient, the presence of fluorescence
leakage along vessels made confusion toward the possibility of
vasculitis association.
Missed retinal breaks in rhegmatogenous retinal detachment are
responsible for almost 65% of the cases of failed retinal detachment
surgery, (6) leading to recurrent retinal detachments. (7) Contact lens
fundus examination with sclera indentation is crucial to avoid missing
retinal breaks.