Sight restoration possible after chronic retinal detachment
MedWire News: Successful visual restoration after long-term blindness caused by retinal detachment during childhood may be possible, report US researchers.
The case, reported in Biomed Central's open access Journal of Medical Case Reports, concerned a 6-year-old Caucasian man with a 55-year history of no light perception secondary to trauma-related childhood retinal detachment of the right eye. The patient presented to hospital complaining of pain, which, on examination, was found to be due to total hyphema and neovascular glaucoma (intraocular pressure of 60 mmHg).
"We believe that our patient was able to regain vision because of the low height of the long-standing retinal detachment," explain Christopher Teng (New York Medical College, Valhalla, USA) and co-investigators.
After glaucoma treatment with monoclonal antibody therapy and reduction of the elevated intraocular pressure, the patient reported light perception in the affected eye.
The researchers reattached the retina surgically, which led to successful visual restoration in the right eye, such that the patient was able to count fingers at a distance of 5 m.
They used two antiglaucoma medications to maintain a normal intraocular pressure of 12-17 mmHg during the 1-year period following surgery, during which time, the eye developed neovascularisation cessation.
However, by the end of the postoperative period, subretinal fibrosis leading to re-detachment of the retina occurred in the right eye. A secondary retinal reattachment was performed alongside removal of fibrotic subretinal tissue, and this led to successful restoration of vision.
"Our patient likely had areas of neurosensory retina intact, which allowed him to have some visual recovery after the retinal procedures," remark Teng and team.
They add: "Additionally, intraocular pressure control likely contributed to the improvement of vision."
Co-investigator Olusola Olawoye concluded that the findings from this case have "implications for restoring eyesight in other patients, especially in the context of stem cell research into progenitor cells which may be able to be transplanted into diseased retinas to restore vision."
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By Lauretta Ihonor