Macular Demarcation Line post Retinal Detachment Repair
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41-year-old man had a retinal detachment repair in the left eye on New Years Eve in December of 2007 in Wake Forest, North Carolina (3 years ago). He was in for an annual check at the time the detachment was discovered and he was told he needed urgent surgery. According to the notes, there was proliferative vitreoretinopathy. He had vitrectomy and scleral buckle done. Since then, although his vision did improve some, he has had problems with distortion and pinching. When he looks at long words, the very center letters are abnormal.
VISUAL ACUITY: Vision OD is 20/20, OS is 20/80. IOP: OD 20, OS 19.
SLIT LAMP EXAM: The right eye has a clear lens. The left eye has 1+ nuclear sclerosis.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.1. There are 1+ optic nerve drusen. There is no posterior vitreous separation. The macula and periphery look healthy.
OS: Vertical C/D ratio is 0.1. The vitreous is empty. The retina is attached. There is a demarcation line that runs immediately through the fovea. The retina is attached on a moderate buckle.
OCT SCAN: The OCT scan shows a near normal foveal contour in each eye. The left eye just has a little bit of a pigment epithelial disturbance just superior to the fovea.
IMPRESSION:
1. STATUS POST MACULA-OFF RETINAL DETACHMENT REPAIR – LEFT EYE
2. HISTORY OF CHRONIC RETINAL DETACHMENT – LEFT EYE
3. MACULAR DEMARCATION LINE – LEFT EYE
DISCUSSION: I explained to the patient unfortunately there is a demarcation line right through the fovea in the left eye which has affected his vision. There is nothing that can be done for that. I asked him to return to see someone every year. He is developing a little bit of a cataract and down the road that might affect his vision. He did have postoperative positioning facedown, so I think at the time of surgery everything was done appropriately. It does not sound like there was ever a macular fold, just the old demarcation line.
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Macular Demarcation line and Symptomatic Distortion 3 years following Asymptomatic Retinal Detachment Repair651 views 41-year-old man had an asymptomatic retinal detachment repair in the left eye on New Years Eve in December of 2007 in Wake Forest, North Carolina (3 years ago). Since then he has had problems with distortion and pinching. When he looks at long words, the very center letters are abnormal.
OD is 20/20, OS is 20/80
(0 votes)
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Macular Demarcation line and Symptomatic Distortion 3 years following Asymptomatic Retinal Detachment Repair434 views 41-year-old man had an asymptomatic retinal detachment repair in the left eye on New Years Eve in December of 2007 in Wake Forest, North Carolina (3 years ago). Since then he has had problems with distortion and pinching. When he looks at long words, the very center letters are abnormal.
OD is 20/20, OS is 20/80
(0 votes)
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Macular Demarcation line and Symptomatic Distortion 3 years following Asymptomatic Retinal Detachment Repair441 views 41-year-old man had an asymptomatic retinal detachment repair in the left eye on New Years Eve in December of 2007 in Wake Forest, North Carolina (3 years ago). Since then he has had problems with distortion and pinching. When he looks at long words, the very center letters are abnormal.
OD is 20/20, OS is 20/80
(0 votes)
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Macular Demarcation line and Symptomatic Distortion 3 years following Asymptomatic Retinal Detachment Repair406 views 41-year-old man had an asymptomatic retinal detachment repair in the left eye on New Years Eve in December of 2007 in Wake Forest, North Carolina (3 years ago). Since then he has had problems with distortion and pinching. When he looks at long words, the very center letters are abnormal.
OD is 20/20, OS is 20/80
(0 votes)
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Macular Demarcation line and Symptomatic Distortion 3 years following Asymptomatic Retinal Detachment Repair891 views 41-year-old man had an asymptomatic retinal detachment repair in the left eye on New Years Eve in December of 2007 in Wake Forest, North Carolina (3 years ago). Since then he has had problems with distortion and pinching. When he looks at long words, the very center letters are abnormal.
OD is 20/20, OS is 20/80
(0 votes)
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41-year-old man had a retinal detachment repair in the left eye on New Years Eve in December of 2007 in Wake Forest, North Carolina (3 years ago). He was in for an annual check at the time the detachment was discovered and he was told he needed urgent surgery. According to the notes, there was proliferative vitreoretinopathy. He had vitrectomy and scleral buckle done. Since then, although his vision did improve some, he has had problems with distortion and pinching. When he looks at long words, the very center letters are abnormal.
VISUAL ACUITY: Vision OD is 20/20, OS is 20/80. IOP: OD 20, OS 19.
SLIT LAMP EXAM: The right eye has a clear lens. The left eye has 1+ nuclear sclerosis.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.1. There are 1+ optic nerve drusen. There is no posterior vitreous separation. The macula and periphery look healthy.
OS: Vertical C/D ratio is 0.1. The vitreous is empty. The retina is attached. There is a demarcation line that runs immediately through the fovea. The retina is attached on a moderate buckle.
OCT SCAN: The OCT scan shows a near normal foveal contour in each eye. The left eye just has a little bit of a pigment epithelial disturbance just superior to the fovea.
IMPRESSION:
1. STATUS POST MACULA-OFF RETINAL DETACHMENT REPAIR – LEFT EYE
2. HISTORY OF CHRONIC RETINAL DETACHMENT – LEFT EYE
3. MACULAR DEMARCATION LINE – LEFT EYE
DISCUSSION: I explained to the patient unfortunately there is a demarcation line right through the fovea in the left eye which has affected his vision. There is nothing that can be done for that. I asked him to return to see someone every year. He is developing a little bit of a cataract and down the road that might affect his vision. He did have postoperative positioning facedown, so I think at the time of surgery everything was done appropriately. It does not sound like there was ever a macular fold, just the old demarcation line.
