Here the originality of our case is the long term follow-up over 10 years hightlighting the possibility after the first year following surgery, to still observe a gain in vision and a complete restoration of the macular anatomy on OCT scans in case of macular detachment due to optic pit reapplication. The visual recovery is particularly described in the literature over the first year after retinal detachment surgery and associated with restoration or not of the EZ or CIZ. During this reappearance phase, the thickness of the EZ-Retinal pigmented epithelium complex and cone density increase, leading to the formation of foveal bulge and good vision after successful reattachment of macula-off rhegmatogenous retinal detachment. The reappearance of outer retinal layers has been already shown to be associated with a good visual acuity recovery following surgery for rhegmatogenous retinal detachment. Spectral-domain optical coherence tomography allows a direct visualization of in vivo retinal morphology and provides informations of the structural postoperative macular changes. g Left eye is unremarkable on Time-domain OCT at baseline and on Spectral-domain OCT 10 years post surgery ( h). e Spectral-domain OCT showing a focal alteration of the ellipsoid zone 5 years after surgery, and ( f) OCT scan showing the perfect reconstitution of the outer retina with enhanced outer layer density and a visual acuity of 20/25, 10 years after surgery. Visual acuity improved to 20/32 at both timepoints. c, d On Time-domain OCT, 1 ( c) and 3 years ( d) after surgery, the area of outer retina disorganization decreased and the ellipsoid zone has returned to normal except at the very center. b 6 months after surgery, reapplication of the edges of the foveal detachment but no outer retina was visible at the center of the retina. a Pre-operative Time-domain OCT showing foveal detachment in 2005. Horizontal optical coherence tomography B-scans (OCT) showing progressive recovery from outer retina disruption due to foveal detachment associated with optic disc pit. OCT of the left eye was unremarkable (Fig. At 10 years follow-up after surgery, his visual acuity has improved to 20/25 and complete restoration of the EZ and the cone interdigitation zone (CIZ) at the fovea was observed (Fig. At 5 years post-surgery, a focal interruption of the ellipsoid zone (EZ) remained (Fig. On OCT scans, a slight disorganization of the photoreceptor layer remained underneath the right fovea at one and 3 years (Fig. By 1 year, the visual acuity has improved to 20/32. Visual acuity improved to 20/40 at 6 months post surgery. The post-operative OCT scans at 6 months showed a wide disorganization of the outer retinal layers with a partial reapplication of the retina (Fig. The patient underwent a pars plana vitrectomy with gas tamponade (C2F6) of his right eye. There was an incomplete macular hole associated with detachment of the boundaries of the macular hole, with loss of the outer retina (Fig. ![]() ![]() Time-domain optical coherence tomography (OCT) revealed a foveal detachment related to an optic disc pit on the right eye. A macular examination revealed an absence of the foveal reflex on the right eye while present on the left eye. A slit-lamp examination of the anterior segment was normal for both eyes without evidence of iris coloboma. The pupils were equal, round, and reactive. The intraocular pressure was normal bilaterally. ![]() His best-corrected visual acuity was 20/100 for the right eye, and 20/20 for the left. ![]() There was no significant medical family history. This healing process may take several years and allow a complete functional restoration.Ī 15 year-old boy with no past medical history presented for a vision loss of the right eye. However, we highlight with this case that in humans, a healing process of the outer retinal layers can occur with reappearance of the ellipsoid zone on OCT. Photoreceptor regeneration after foveal detachment surgery has been already described only in zebrafish but never humans. OCT scans showed a progressive long-term retinal healing with reappearance of the ellipsoid line and visual acuity improved from 20/100 before surgery to 20/25, 10 years after surgery. The foveal detachment was successfully reattached with complete reapplication of the retina. Optical coherence tomography (OCT) follow-up was performed on a 15-year-old boy with deep optic disc pit and foveal detachment, before and for 10 years after vitrectomy with gas. To report a case of complete progressive visual recovery and healing of outer retinal layers after vitrectomy for foveal detachment associated with optic disc pit.
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