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Irma Ahmed, MD; H. Richard McDonald, MD; Howard Schatz, MD; Robert N. Johnson, MD; Everett Ai, MD; Alan F. Cruess, MD, FRCSC; Joe Robertson, MD; Richard S. Munsen, MD; Craig G. Wells, MD

Arch Ophthalmol. 1998;116:1449-1453.

Objective  To describe the presence of crystalline opacities located at the level of the inner retina in patients with chronic retinal detachment.

Methods  We reviewed the clinical records, fundus photographs, and fluorescein angiograms of patients with superficial retinal crystals in the presence of a chronic retinal detachment.

Results  Eleven eyes in 11 patients with chronic retinal detachment were found to have these peculiar crystalline opacities on the inner retinal surface. In 5 patients, the crystalline opacities were noted on initial assessment prior to surgery and persisted without change in appearance or number after surgical repair. In 6 eyes, the crystals were not appreciated until after surgical repair of the retinal detachment. The crystals appeared similar in all 11 eyes, were highly refractile, and were located in the posterior pole. Eight of the eyes had retinal detachment associated with retinal dialysis and 6 of these had a history of trauma. There was a definite history of vitreous hemorrhage in 2 eyes. The crystals did not seem to be associated with any visual deficit.

Conclusions  Chronic retinal detachment can be associated with crystals on the inner retinal suface. The cause and composition of these crystals are unknown. They seem to be visually inconsequential and unchanging.

From the Department of Ophthalmology, California Pacific Medical Center (Drs Ahmed and Ai) and Retina Research Fund, St Mary's Medical Center (Drs McDonald, Schatz, and Johnson), San Fransisco; Queen's University, Kingston, Ontario (Dr Cruess); Casey Eye Institute, Oregon Health Sciences University, Portland (Dr Robertson); and University of Washington, Seattle, Wash (Dr Wells). Dr Munsen is in private practice in Seattle.

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