Persistent Loculated Subretinal Fluid After Rhegmatogenous Retinal Detachment Surgery

Abstract

Purpose: To identify factors associated with persistent subretinal fluid (SRF) after small-gauge pars plana vitrectomy for primary rhegmatogenous retinal detachment. Methods: This retrospective study included patients from 2 tertiary centers who underwent pars plana vitrectomy for repair of rhegmatogenous retinal detachment between 2013 and 2016. Preoperative and intraoperative parameters were examined for association with development of SRF. Results: Overall, 153 eyes of 153 patients, mean age of 55.2 ± 17.9 years were included. Persistent SRF occurred in 15.0% (n = 23) and was associated with high myopia (65.22 vs. 26.15%, P < 0.001), macula-involving retinal detachment (91.30 vs. 66.15%, P = 0.02), phakic lens status (86.96 vs. 66.15%, P = 0.04), and younger age (47.8 ± 18.7 vs. 56.5 ± 17.5, P = 0.04) while drainage retinotomy was protective (13.04 vs. 34.11%, P = 0.04). In multivariate analysis, high myopia (P = 0.009) and macula-involving retinal detachment (P = 0.004) were associated with SRF, while drainage retinotomy was protective (P = 0.03). Persistent SRF was associated with outer retinal band irregularity (30.4 vs. 9.3%, P = 0.005). There were no significant differences in terms of change in best-corrected visual acuity from presentation (P = 0.70), or final best-corrected visual acuity (P = 0.54). Conclusion: Eyes with preoperative high myopia and macular involvement, and those in which a drainage retinotomy was not performed, were more likely to develop persistent SRF.

Multifactor analysis of delayed absorption of subretinal fluid after scleral buckling surgery

“…RRD, which is the detachment of the retinal neuroepithelial layer from the retinal pigment epithelium (RPE) caused by breaks in the retina. This allows fluid from the vitreous to enter the cavity of subretinal, which can cause permanent loss of vision if left untreated [8,9]. Previous studies have reported poor visual recovery and high incidence of persistent subretinal fluid (PSF) in patients with macula-off RRD [10].…”

Effect of High Myopia on Delayed Absorption of Subretinal Fluid after Scleral Buckling Surgery

“…It has been reported that age is another major factor leading to persistent SR and other research have shown that younger patients have a higher probability of SRF absorption after SB [9,10]. Michael et al [1] explored the factors of persistent S PPV, and the results showed that high myopia could lead to delayed absorption while younger age was not associated with persistent SRF. They considered that t ning and retrogradation of RPE and atrophy of the choroid in high myopia might a decrease in blood pumping function, thus affecting SRF absorption.…”

“…Persistent subretinal fluid (SRF) refers to the presence of a small amount of subretinal fluid in the macular area detected in optical coherence tomography (OCT) after successful retinal reattachment in RRD patients. This condition is most common after scleral buckling (SB), and the reason for its occurrence and development is not clear [1]. Studies have shown that more than 50% of patients have persistent SRF after SB, compared to only 0-15% after pars plana vitrectomy (PPV) [2,3].…”

“…In myopia, a larger eyeball volume leads to RRD through earlier posterior vitreous detachment, common lattice degeneration, and a thinner retina than in emmetropia [5]. Michael et al [1] explored the factors of persistent SRF after PPV and found that high myopia was a significant factor in the occurrence of SRF after RRD surgery. Therefore, the purpose of this study was to investigate whether patients with high myopia who underwent SB surgery were more likely to develop persistent SRF and the possible influencing mechanism of high myopia on delayed SRF absorption.…”

Retinal pigment epithelial step sign: optical coherence tomography clue for diagnosing retained subretinal perfluorocarbon liquid

“…Strampe et al 2 have reported image artefacts of handheld spectral domain OCT images of retained PFCL droplets on the surface of the retina ascribing to a lensing effect produced by the refractive index differences between the PFCL and vitreous humour. 1 3 The clinical application of this sign is in recognising the nature of fluid trapped under the retina that cannot be assessed clinically, the most common being persistent loculated subretinal fluid (PSF) after small gauge vitrectomy for retinal detachment as reported by Mimouni et al 4 PSF can be observed while retained subretinal PFCL mandates surgical intervention. Another close mimicker is the presence of subretinal cysticercosis, which mimics subretinal PFCL clinically and also on many features on OCT, though there is no underlying RPE step.…”