Enlightening new underpinnings in hydration retinal folds.

Purpose: To describe and value a peculiar alteration typically found in rhegmatogenous retinal detachment raising news foundations of its role in the photoreceptors and visual prognosis.

Design: Case description and rationale formulation.

Subjects: An isolated case.

Intervention: We report a case of a 52-year-old male patient complaining of sudden visual acuity (VA) loss in the left eye. Fundoscopic findings revealed rhegmatogenous retinal detachment, macula off, and an isolated horseshoe tear in the infero-temporal periphery. Spectral-domain optical coherence tomography (SD-OCT) evinced prominent hydration retinal folds.

Main Outcome Measures: Restructuring of the retinal layers, visual acuity and complaints.

Results: The patient underwent scleral buckling surgery with complete re-attachment of the retina and significant improvement of the hydration retinal folds. In addition, there was resolution of visual symptoms, with a final VA of 20/30.

Conclusions: We speculate that the increase in arc length of the outer retina generates a centripetal force towards the fovea. Its association with the higher density of photoreceptors in this region, generates resistance in the water inflow, preventing swelling and cellular damage of the central photoreceptors.