Pigment epithelial detachment is usually associated with disorders of the underlying Bruch's membrane and choroid in a context of age-related macular degeneration. In a very few cases, lesions resembling pigment epithelial detachment have been reported after retinal reattachment surgery. We observed an additional case who presented deep lesions several weeks after a scleral buckling procedure for retinal detachment. The lesions, all located posteriorly at the edge of the reattached retina, appeared to be subretinal, well circumscribed and yellowish with a normal overlying retina. All exhibited the typical biomicroscopic features of focal detachment of the retinal pigment epithelium (RPE) but failed to show, throughout the angiogram, the typical fluorescein pooling of the classic pigment epithelial detachment. This suggests that these lesions, though simulating RPE detachments, represent focal pockets of subretinal fluid.
Female Fluorescein Angiography