Relaxation of encircling buckle improved choroidal blood flow in a patient with visual field defect following encircling procedure.
BACKGROUND: We report a patient with a visual field defect after retinal reattachment by the encircling procedure for rhegmatogenous retinal detachment. We confirmed improved ocular blood flow after relaxation of the buckle. CASE: A 24-year-old woman with a visual field defect appearing after an encircling procedure for rhegmatogenous retinal detachment. OBSERVATIONS: Before and after relaxing the encircling buckle, we measured tissue blood flow in the fundus of each eye of the patient using a Heidelberg retina flow meter. Preoperative measurements showed a reduction of blood flow at the disc rim in the diseased fundus, while retinal blood flow was not reduced (P = 0.026, disc rim area versus retinal area, one-factor analysis of variance, ANOVA). Indocyanine green angiography showed extensive peripheral filling delay. Electroretinography showed low a-wave and b-wave amplitudes, but normal oscillatory potential. The base value of the electro-oculogram was severely reduced in the right eye. The blood flow values after surgery indicated a significant improvement of blood flow (P = 0.01, one-factor ANOVA). No further progression in the visual field defect was observed, and visual acuity of the right eye improved from 0.8 to more than 1.0. CONCLUSIONS: These results suggest that the choroidal circulation disturbance, which was found after the encircling procedure, had a plausible role in the development of the visual field defect.