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Persistent subretinal fluid after surgery for rhegmatogenous retinal detachment: hypothesis and review

  • Retinal Disorders
  • Published:
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Abstract

Background

Persistent subretinal fluid after rhegmatogenous retinal detachment (RRD) surgery is responsible for delayed recovery, and may affect the final visual outcome. Cause, consequences, and treatment remain elusive.

Design

Literature review and case series.

Methods

We reviewed the pathophysiological principles and therapeutic options from the literature, and we report the results from a subretinal fluid cytology study. Nine eyes from nine patients with macula-involving RRD underwent surgical repair. The cellular content of subretinal fluid (SRF) was studied by electron microscopy and anti-rhodopsin immunostaining. All eyes were assessed postoperatively with optical coherence tomography for the detection of persistent submacular fluid (PSF) (Ethics Committee Ghent University Hospital, registration number B6702006169).

Results

Certain patient characteristics as well as surgical methods were implicated. PSF appears to occur more frequently in patients with longstanding detachments treated with buckling surgery. Several therapeutic options have been suggested but safety and efficacy remain unclear. We found PSF in three eyes on postoperative OCT scans, which corresponded to the three cell-rich subretinal samples.

Conclusions

PSF after successful RRD repair seems to be related to fluid composition. We hypothesize, in the absence of an effective treatment, that a modified surgical drainage, including a washout of the subretinal space, could evacuate the subretinal fluid more completely, and may prevent this complication.

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Author information

Authors and Affiliations

  1. Rotterdam Eye Hospital, Vitreoretinal Surgery, Schiedamse vest 180, 3000LM, Rotterdam, the Netherlands

    M. Veckeneer, E. W. Lindstedt & J. van Meurs

  2. Upper Airway Research Laboratory, Ghent University Hospital, Ghent, Belgium

    L. Derycke

  3. Laboratory of Experimental Cancerology, Ghent University Hospital, Ghent, Belgium

    L. Derycke & M. Bracke

  4. Department of Anatomy, Embryology and Histology, Ghent University Hospital, Ghent, Belgium

    M. Cornelissen

  5. Department of Ophthalmology, Ghent University Hospital, Ghent, Belgium

    E. Van Aken

Authors
  1. M. Veckeneer
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  2. L. Derycke
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  3. E. W. Lindstedt
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  4. J. van Meurs
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  5. M. Cornelissen
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  6. M. Bracke
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  7. E. Van Aken
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Corresponding author

Correspondence to E. W. Lindstedt.

Additional information

Supported by SWOO Grant 2005–15, Stichting Wetenschappelijk Onderzoek Oogziekenhuis.

The authors have no proprietary interest in any material presented in this paper.

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Veckeneer, M., Derycke, L., Lindstedt, E.W. et al. Persistent subretinal fluid after surgery for rhegmatogenous retinal detachment: hypothesis and review. Graefes Arch Clin Exp Ophthalmol 250, 795–802 (2012). https://doi.org/10.1007/s00417-011-1870-y

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  • DOI: https://doi.org/10.1007/s00417-011-1870-y

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