First Author: E.Compains Silva SPAIN
Co Author(s): D. Aliseda C. Abascal P. Plaza
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Rhegmatogenous retinal detachment (RRD) is a fairly common sight-threatening disease. Despite successful anatomical repair, reported in 90% of the patients, visual acuity usually does not return to baseline when the RRD involves the macula preoperatively. Only 30-40% of the cases have final best corrected visual acuity better than 4/10. Persistent subretinal fluid and changes in external retinal layers have been reported as two of the factors of poor visual recovery after RRD surgery. However, other reported studies contradic this finding by reporting that the presence of subretinal fluid after successful surgery for RRD did not influence final visual acuity (VA).
To evaluate serially long-term macular morphologic changes in 5 patients with persistent subretinal fluid after succesful macula-involving RRD surgery and correlate this with final visual acuity.
Repeat SD-OCT imagin and VA in 5 eyes with a 2 year follow up period after succesful macula-involving RRD surgery with presence of persistent subretinal fluid in the follow-up.
The mean follow up after RRD repair was 1.5 months for the first OCT and 20 months for the follow-up period. 3 eyes with a final best-corrected visual acuity (BCVA) >20/40 had a progressive resolution of the subretinal fluid on serial SD-OCT, wich correlated with improvement in VA. 2 of these eyes had an intact external limiting membrane (ELM) initially and the third one had a initially disrupted ELM with a progressive recovery during the follow up period. 2 eyes with poor or worsening BCVA on follow up had a initially disrupted ELM and a persistent or progressive ellipsoid zone (EZ) disruption in serial OCT. In these two eyes there has been a progressive resolution of the subretinal fluid.
Macular function may progressively improve or worsen long-term after successful RRD repair. Progressive resolution of subretinal fluid and/or EZ disruption on SD-OCT correlated with imporvement in macular function, whereas worsening or persistent EZ disruption correlates with worsening or persistently poor visual outcome. The natural course of the subretinal fluid after RRD surgery is to a progressive resolution of the fluid without any additional intervention, and it is correlated with visual improvement when it occurs.