Supplementary Material for: Spontaneous Retinal Reattachment Following Multiple Vitreoretinal Interventions Case Report

Introduction
To document and analyze a rare case of spontaneous retinal reattachment in a patient after successive unsuccessful vitreoretinal surgeries and to explore potential mechanisms contributing to this unexpected outcome.
Case Presentation
A 61-year-old patient with a history of high myopia presented with a rhegmatogenous retinal detachment. After undergoing multiple vitreoretinal procedures, including pars plana vitrectomy with silicone oil tamponade, anatomical reattachment was not achieved, and the patient developed complex retinal detachment associated with myopic foveoschisis. Surprisingly, spontaneous reattachment of the retina was observed during routine follow-up. Comprehensive ocular examination, optical coherence tomography (OCT), and fundus autofluorescence imaging were utilized to confirm and document the retinal status. A thorough review of patient history, surgical reports, and postoperative imaging was performed to discern potential contributory factors. The patient's retina remained attached for 12 months after the last intervention without additional surgical or medical treatment. OCT images revealed normalization of retinal architecture with reestablishment of the foveal contour and partial recovery of visual acuity. No signs of proliferative vitreoretinopathy (PVR) or other commonly associated complications were observed. Immunological assays and genetic testing ruled out systemic conditions that could predispose to spontaneous reattachment.
Conclusion
This case represents a remarkable instance of spontaneous retinal reattachment without surgical intervention after multiple failed procedures. The mechanisms underlying this phenomenon remain speculative; however, they may involve delayed postoperative cellular proliferation and migration, subtle intraocular pressure changes, or unrecognized vitreous traction resolution. Further investigation into similar cases may provide insights into the natural history of retinal detachment and potential self-resolving dynamics, which could inform future therapeutic strategies.

引言
旨在记录并分析一名患者在连续多次玻璃体视网膜手术失败后出现罕见自发性视网膜再附着的病例，并探讨导致这一意外结果的可能机制。
病例报告
一名61岁的患者，既往有高度近视病史，出现牵拉性视网膜脱离。在经历了包括玻璃体切除术联合硅油填充在内的多次玻璃体视网膜手术治疗后，未能实现解剖性视网膜再附着，且患者出现与近视性黄斑裂孔相关的复杂视网膜脱离。令人惊讶的是，在常规随访期间观察到视网膜自发再附着。通过全面的眼科检查、光学相干断层扫描（OCT）和眼底自发光成像，证实并记录了视网膜的状态。对患者的病史、手术报告和术后成像进行了彻底的回顾，以识别可能的促成因素。患者在最后一次干预后的12个月内视网膜保持附着，未接受额外的手术治疗或药物治疗。OCT图像显示视网膜结构恢复正常，黄斑轮廓重建，视力部分恢复。未观察到增殖性玻璃体视网膜病变（PVR）或其他常见并发症的迹象。免疫学检测和遗传测试排除了可能导致自发再附着的系统性疾病的可能性。
结论
本病例代表了一例在多次手术失败后无需手术干预而自发视网膜再附着的显著实例。这一现象背后的机制尚属推测；然而，它们可能涉及术后细胞增殖和迁移的延迟、细微的眼内压变化或未被识别的玻璃体牵引力缓解。对类似病例的进一步研究可能有助于揭示视网膜脱离的自然病程和潜在的自行缓解动力学，从而为未来的治疗策略提供信息。