title: Relaxation of encircling buckle improved choroidal blood flow in a patient with visual field defect following encircling procedure.
abstract: BACKGROUND
  We report a patient with a visual field defect after retinal reattachment by the encircling procedure for rhegmatogenous retinal detachment. We confirmed improved ocular blood flow after relaxation of the buckle.
  
  
  METHODS
  A 24-year-old woman with a visual field defect appearing after an encircling procedure for rhegmatogenous retinal detachment.
  
  
  METHODS
  Before and after relaxing the encircling buckle, we measured tissue blood flow in the fundus of each eye of the patient using a Heidelberg retina flow meter. Preoperative measurements showed a reduction of blood flow at the disc rim in the diseased fundus, while retinal blood flow was not reduced (P = 0.026, disc rim area versus retinal area, one-factor analysis of variance, ANOVA). Indocyanine green angiography showed extensive peripheral filling delay. Electroretinography showed low a-wave and b-wave amplitudes, but normal oscillatory potential. The base value of the electro-oculogram was severely reduced in the right eye. The blood flow values after surgery indicated a significant improvement of blood flow (P = 0.01, one-factor ANOVA). No further progression in the visual field defect was observed, and visual acuity of the right eye improved from 0.8 to more than 1.0.
  
  
  CONCLUSIONS
  These results suggest that the choroidal circulation disturbance, which was found after the encircling procedure, had a plausible role in the development of the visual field defect.
authors.affiliation: Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan. kimura@sc.itc.keio.ac.jp.|Laboratory of Clinical Epidemiology, National Institute of Sensory Organs, Tokyo, Japan. kimura@sc.itc.keio.ac.jp.
authors.forename: Itaru
authors.initials: I
authors.lastname: Kimura
authors.affiliation: Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.|Laboratory of Visual Physiology, National Institute of Sensory Organs, Tokyo, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Shinoda
authors.affiliation: Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Tadahiko
authors.initials: T
authors.lastname: Eshita
authors.affiliation: Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Inoue
authors.affiliation: Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Mashima
mesh_terms: D000328:Adult; D002829:Choroid / Q000098:blood supply*; D004596:Electroretinography; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D012039:Regional Blood Flow / Q000502:physiology; D012163:Retinal Detachment / Q000601:surgery*; D012591:Scleral Buckling / Q000379:methods*; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D014794:Visual Fields
chemical_list: D007208:Indocyanine Green