Œdème maculaire cystoïde révélateur d’une nécrose sclérale secondaire à une indentation sclérale

Abstract

Macular edema is a very rare complication of scleral necrosis after scleral buckling surgery. We report the case of a 45-year-old women with an ocular history of severe myopia in both eyes and retinal detachment in the left eye. She underwent segmental scleral buckling in 2003. Two years and nine months later, the patient had acute, painless visual loss in her left eye. Funduscopic examination revealed cystoid macular edema with no intraocular inflammation. A fluorescein angiography and OCT revealing cystoid macular edema consistent with the macular edema was noted clinically. The surgical exploration revealed scleral necrosis beneath the scleral buckle. After removal of the scleral buckle, a scleral patch was performed. Several months after surgery, the vision had improved; funduscopic examination and OCT revealed no residual macular thickening. Macular edema is a rare complication of scleral necrosis following scleral buckling surgery, with only one case described in the literature. Our patient's complication occurred 2 years after surgery. The macular edema is likely the result of the scleritis. This inflammatory process can extend from the sclera and result in several ocular complications, including uveitis. Regression of macular edema occurs frequently after removal of the scleral buckle.