• Yumiko Yonemoto, Seita Morishita, Masanori Fukumoto, Masashi Mimura, Takaki Sato, Teruyo Kida, Shota Kojima, Hidehiro Oku, Jun Sugasawa, and Tsunehiko Ikeda.
• Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka, Japan.
• Medicine (Baltimore). 2018 Jun 1; 97 (22): e10896.

RationaleThe aim of this study was to report a case of Down syndrome (DS) complicated with bilateral retinal detachment (RD) due to unusual retinal degeneration.Patient ConcernsA 9-year-old girl complained of bilateral visual disturbance during a follow-up examination for myopia and strabismus.DiagnosesSlit-lamp examination revealed moderate posterior subcapsular cataract in both eyes. B-mode echography showed bilateral bullous RD; however, it was difficult to detect the causal retinal breaks due to poor mydriasis.InterventionsFor treatment, the patient underwent bilateral lensectomy, vitrectomy, and silicone oil tamponade.OutcomesIntraoperative findings revealed symmetrical retinal breaks and unusual caterpillar-like retinal degeneration on the upper temporal side of both eyes. Three months later, the patient underwent bilateral silicone oil removal and intraocular lens implantation.LessonsIn this case, the retinal degeneration was morphologically different from retinal lattice degeneration, thus suggesting that it might be involved in the onset of DS-related bilateral RD.

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