Panuveitis-like reaction following encircling laser retinopexy/cerclage in a 21-year-old male

• Main Authors: David Francis Fullon Chan, Milagros Herrera-Arroyo, Darby E. Santiago, Teresita R. Castillo, Ma Florentina Q. Fajardo-Gomez
• Format: Article
• Language: English
• Published: SpringerOpen 2017-10-01
• Series: Journal of Ophthalmic Inflammation and Infection
• Subjects: Encircling laser retinopexy; Laser cerclage; Retinal detachment prophylaxis; Retinal detachment; Retinal laser/photocoagulation; Post-laser inflammation
• Online Access: http://link.springer.com/article/10.1186/s12348-017-0139-y

Abstract Background Severe vision-impairing ocular inflammation is rarely reported following extensive laser. Previous cases have involved retinal photocoagulation for diabetic retinopathy resolving over days. This report documents a rare instance of this where encircling retinopexy/cerclage was done as fellow eye retinal detachment prophylaxis in a patient with no overt comorbidities. Results A panuveitis-like reaction with severe, near-total visual impairment was documented 1 day following single-sitting encircling laser retinopexy/cerclage done as fellow eye prophylaxis for a 21-year-old male presenting with total retinal detachment in the other eye. Pre-laser findings were unremarkable, other than an equatorial ring of fine vitreous condensations. Pre-laser vision of 20/20 uncorrected decreased to hand motion, light perception on all quadrants, accompanied by severe anterior segment inflammation with hypopyon, retrolental membranes, vitreous cells, and choroidal effusion/suspicious exudative retinal detachment on B-scan ultrasound and ultrasound biomicroscopy. Combination of oral, topical, and depot steroids resulted in restoration of vision by 1 month post-laser, but with persistent anterior segment inflammation and retrolental membranes at month 2 post-laser. Conclusions The atypically inordinate degree of post-laser inflammation and multiple sequelae following encircling retinopexy/cerclage as retinal detachment prophylaxis, in this case, demonstrate the potency and risks of retinal photocoagulation. The value of pre-laser assessment for potential risk factors, caution and mindfulness in conducting the intervention, and, the value of prudent and thorough follow-up are exhibited in this case.