Description

A healthy 22-year-old man presented with decreased vision OD for 1 month. There was no history of trauma. Best-corrected visual acuity (BCVA) was 20/400 OD and 20/20 OS. Anterior segment OU was normal. Dilated fundus examination OD (figure 1A) showed large inferotemporal retinal dialysis (black arrows), an intraretinal macrocyst at its edge (blue arrowheads) and rhegmatogenous retinal detachment (RRD) reaching up to the fovea. Yellowish-white vitreous opacities were noted in the inferior fundus (blue arrows). Fundus OS (figure 1B) showed a large inferotemporal dialysis with microcystoid changes at its edge. The patient was diagnosed with bilateral idiopathic retinal dialysis, and underwent scleral buckling in OD and laser photocoagulation in OS. BCVA OD at 1 month was 20/80 with attached retina. The clinical picture remained stable at 3 months follow-up.

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Figure 1

Ultra-wide field pseudocolour photographs of the right (1A) and left (1B) eyes, showing bilateral idiopathic retinal dialysis with retinal detachment in the right eye. Black arrows, blue arrowheads and blue arrows in figure 1 A show retinal dialysis, intraretinal macrocyst and vitreous opacities, respectively.

Idiopathic retinal dialysis is characteristically bilateral, involves the inferotemporal quadrant and leads to slowly progressive RRD.1 These images highlight the importance of screening inferotemporal periphery of fellow eyes of all patients with RRD due to inferotemporal dialysis.

Ultra-wide field (UWF) imaging using an Optos T×200 (Optos PLC, Dunfermline, Scotland, UK) can be useful for retinal periphery examination and documentation. The apparatus images up to 200° of the retina and provides quick, high-resolution images of the retina, without requiring extensive patient cooperation. UWF imaging has been found useful in patients with retinal detachment.2 In the current case, UWF imaging was able to document the peripheral features of the retina, for which one has to rely on coloured fundus drawings. It also helps clinicians when counselling patients.