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Open Access Case report

Refractile superficial retinal crystals and chronic retinal detachment: Case report

Maged S Habib1*, Sinead Byrne1, John H McCarthy2 and David HW Steel1

Author Affiliations

1 Sunderland Eye Infirmary, Queen Alexandra Road, Sunderland. SR2 9HP. UK

2 Pathology Department, Gloucestershire Royal Hospital NHS Trust, Great Western Road. Gloucestershire. GL1 3NN UK

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BMC Ophthalmology 2006, 6:3  doi:10.1186/1471-2415-6-3

Published: 13 January 2006



Few previous reports have described the presence of retinal refractile opacities at the macular area in patients presenting with longstanding peripheral retinal detachment. The exact nature of these opacities is unknown.

Case presentation

Two patients were referred with an abnormal appearance of refractile opacities in the macular area noted during routine examination. Both were found to have longstanding peripheral retinal detachments. Subretinal fluid analysis of one patient revealed the presence of multiple birefringent crystals. We hypothesise that these crystals are the origin of the refractile macular opacities noted.


This report describes the rare presentation of asymptomatic peripheral retinal detachment by the detection of refractile macular opacities on routine examination. It highlights the importance of meticulous peripheral retinal examination in these cases. The article also describes the findings of the subretinal fluid analysis and discusses the possible hypothesis behind their appearance.