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Outer Retinal Tubulation Associated With Chronic Retinal Detachment.

Various retinal disorders showing disruption or atrophy of the retinal pigment epithelium and the outer retina may be accompanied by outer retinal tubulation (ORT).1,2 It has been mainly reported not only in agerelated macular degeneration but also in retinal dystrophies, mitochondrial diseases, multifocal choroiditis, Fig. 1. Multimodal imaging of outer retinal tubulation in chronically detached retina. A. Ultrawide field color fundus photograph showing a superior retinal hole associated with a partial retinal detachment involving the superior retina. Lattice degeneration is observed on the temporal and supero-nasal retina. B. Spectral domain optical coherence tomography (SD-OCT) shows disruption of the ellipsoid and interdigitation zone in the central macula, as seen in the magnification (orange box). C. Near-infrared reflectance image of the superior retina showing hyperreflective linear lesions corresponding to the areas of subretinal fibrosis (yellow arrowheads).D. Spectral domain optical coherence tomography scan showing multiple cross-sectional areas of outer retinal tubulation (green arrowheads) not only in association with subretinal fibrosis (blue arrows) but also outside the area of subretinal fibrosis (purple arrowhead). I-II. Magnification of the SD-OCT scans (green and blue boxes) in the corresponding areas in image C, showing the typical appearance of ORT (green arrowheads) as structures located in the outer nuclear layer characterized by a hyperreflective band with hyporeflective lumen. We also observe areas of subretinal fibrosis adhering to the outer retina surface (blue arrows).