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.