PMC4166256_01
Central 24 degree perimetry from May 2011 showing peripheral deep defects and no defects within the 10 central degrees. Foveal threshold is zero dB (shown by oval gray line).
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However, the foveal threshold was zero dB (Figure 1), while the normal value is usually 30 dB or more.
Central 10 degree perimetry from July 2011 revealing a small perifoveal scotoma with a sensitivity of 9 dB (indicated by the gray circle in the left numerical pattern).
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Although the intraocular pressure was successfully managed with topical medication, 2 months later, perimetry revealed a small central scotoma (9 dB) within the central 10 degrees with no foveal threshold improvement (Figure 2).
Central 10 degree perimetry from April 2013 showing disappearance of the previous scotoma and sensitivity improvement to 28 dB at the same point (shown by gray circle in the left numerical pattern). Foveal threshold increased to 21 dB (shown by oval gray line).
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The central visual defect disappeared unexpectedly almost 2 years after the last surgical procedure, with a sensitivity increase to 28 dB and foveal threshold improvement from zero to 21 dB (Figure 3); visual acuity was still 20/200, and the patient did not experience any subjective improvement.
Fluorescein angiography showing no abnormalities.
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Fluorescein angiography was unremarkable (Figure 4), and electrophysio logy findings (electro-ocular retinography, and pattern and multifocal electroretinograms) were normal.
Associated B-scan optical coherence tomography showing normal anatomy of the macula.
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Ltd., Gamagori, Japan; Spectralis OCT, Heidelberg Engineering Inc., Heidelberg, Germany), did not show any architectural abnormalities of the retinal layers (Figure 5).
Associated "en-face" optical coherence tomography scan showing a small shiny gray-white area adjacent to the foveal depression at the level of the inner limiting membrane (marked by red arrow).. Abbreviations: ILM, inner limiting membrane; IPL, inner plexiform layer; RPE, retinal pigment epithelium.
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A small shiny gray-white area adjacent to the foveal depression observed by "en face" scan OCT at the level of the inner limiting membrane (Figure 6) perfectly matched an area adjacent to the foveal depression observed on enhanced color fundus photography (Figure 7).
Color fundus enhanced photograph showing the same image observed in the "en-face scan" optical coherence tomography (marked by pink arrow).
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A small shiny gray-white area adjacent to the foveal depression observed by "en face" scan OCT at the level of the inner limiting membrane (Figure 6) perfectly matched an area adjacent to the foveal depression observed on enhanced color fundus photography (Figure 7).
Dense B-scan optical coherence tomograph through the whitish area showing no abnormalities.
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However, B-scan did not show any defect in the area (Figure 8).
B-scan optical coherence tomographic image through the optic disc showing no silicone oil trapped.
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Equally, OCT B-scan of the optic nerve head did not show remnants of silicone oil (Figure 9).