Case Presentation
A seven-year-old child presented to the clinic with a complaint of decreased vision in the right eye for nine days duration. No past history of photopsia or ocular trauma was present. Ophthalmic examination of the right eye showed the best-corrected visual acuity (BCVA) is 0.1, the presence of pigment cells in the anterior vitreous, white without pressure temporal lesions, and shallow inferior RD reaching the macula. The left eye exam was unremarkable except for temporal white without pressure lesions. No retinal break or telangiectasia was detected by using a 90 Volk noncontact lens in fundus examination. Optical coherence tomography (OCT) for the right eye showed macula-off RD. (Fig-1) Even though the border of detachment was convex, the gravity dependency of fluid and the presence of smoothness or corrugations of the retinal surface cannot be judged well due to the shallowness of detachment. B scan -to rule out posterior scleritis-showed unremarkable findings. In addition, FFA was ordered since the causes of exudative retinal detachment including vasculitis, need to be excluded. The results showed retinal vascular leakage corresponding to the inferior area of detachment. (Fig-2)Hence, a vasculitis work-up was ordered which showed unremarkable findings.
Contact lens fundus examination showed inferior dialysis from 5.00 to 7.00 clockwise, which was managed with buckling surgery.(Fig-3) On follow-up examination, BCVA was improved to 0.4, the retina was flat and the leakage on repeating FFA after eight months was absent. (Fig-4) The patient was on regular follow-up for 2 years post-surgery with a stable examination.