A chemical analysis of subretinal fluid was made in 15 patients (16 eyes) who had undergone retinal detachment surgery from March 1, 1991 to July 31, 1991 at St. Mary's Hospital, Catholic University Medical College. The protein concentration of subretinal fluid ranged from 1.0gm/dl to 7.1gm/dl, and the average protein concentration of subretinal fluid of retinal detachment for 90 days or more showed 5.13 +/- 1.71gm/dl and that of subretinal fluid of retinal detachment for less than 90 days was 2.06 +/- 1.29gm/dl. This revealed increasing tendency of protein concentration in proportion to the duration of detachment (p<.05), and the protein concentration of subretinal fluid did not show any differences according to the size of retinal detachment. Sugar ranged from 32mg/dl to 96mg/dl, and chloride was from 92mEq/L to 126mEq/L. From this study, we found that the protein concentration of subretinal fluid increased in proportion to the duration of retinal detachment. On the contrary, sugar and chloride concentration was not related to the duration of retinal detachment.
Humans ; Retinal Detachment* ; Retinaldehyde* ; Subretinal Fluid*

PURPOSE: To evaluate outcomes of intravitreal aflibercept in cases resistant to bevacizumab and ranibizumab in neovascular age-related macular degeneration. METHODS: Twenty patients with neovascular age-related macular generation who were resistant to treatment with bevacizumab and ranibizumab were evaluated. After switching to aflibercept the best corrected visual acuity (BCVA) and central retinal thickness (CRT) were compared at baseline and at 1 month after injection. Additionally, changes in the intraretinal fluid, subretinal fluid and pigment epithelial detachment were evaluated. RESULTS: The mean BCVA was 0.83 +/- 0.56 log MAR and the mean CRT was 294.20 +/- 12.99 microm before aflibercept treatment. After switching to aflibercept the mean BCVA was 0.86 +/- 0.61 log MAR with no statistical difference (p = 0.406) and the mean CRT was decreased to 232.45 +/- 12.05 microm (p = 0.011). After 1 month of aflibercept injections, a reduction of intraretinal fluid in 4 eyes (80%), reduction of subretinal fluid in 11 eyes (78.6%) and reduction of pigment epithelial detachment in 5 eyes (50%) were observed. Increases in fluid or new lesions were not observed. CONCLUSIONS: Aflibercept injection appears beneficial in patients with neovascular age-related macular generation who are resistant to bavacizumab and ranibizumab treatment.
Humans ; Macular Degeneration* ; Retinaldehyde ; Subretinal Fluid ; Visual Acuity ; Bevacizumab ; Ranibizumab

An anaysis has been made of 86 eyes of retinal detachment treated surgically in our hospital during the last 3yrs. The final complete failure rate was 16.6% (14 eyes), and the failure rate in the first operation was 25.5% (24 eyes). The preoperative factors that were found to be significant in leading to failure were young age, delay of surgery over 6 months, large extent of detachment, giant tear and fibrosis of vitreous or retina. The failure rate in the first operation due to inadequate surgical techniques was 32%, and subretinal fluid drainage was not contributory to the failure rate. It was noteworthy that 64% of failed cases were due to M.V.R. Adnavces in knowledge of pathophysiology of vitreous in complicated retinal detachment and in technique of vitreous surgery may reduce the failure rate.
Drainage ; Fibrosis ; Retina ; Retinal Detachment* ; Retinaldehyde* ; Subretinal Fluid

Description histopathologic pictures of rhegmatogenous retinal dctachment in its early stase to late stage is reviewed. Histology on the results of experimental retinal detachment and reattachment is introduced with short comment. Formatlon of subretinal fluid in retinal detachment is a complex and dynamic processes involving alterations in retinal and choroidal structures and metabolism of vitreal components. Peripheral retinal degenerations as predispoing features of retinal detachment are listed. Some pathologic findings following retinal detachment surgeries of clinical importances are noted briefly.
Choroid ; Metabolism ; Pathology* ; Retinal Degeneration ; Retinal Detachment* ; Retinaldehyde* ; Subretinal Fluid

Objective: This study determined the incidence of macular abnormalities detected by optical coherence tomography (OCT) among patients who have undergone retinal-detachment surgery and investigated the association between pre- and postoperative vision, macular thickness, duration of detachment, and type of surgery done with respect to OCT findings. Methods: This is a noncomparative, nonconsecutive prospective case series of 41 eyes with unsatisfactory vision after scleral buckling, vitrectomy, or pneumatic retinopexy. OCT of the macula were taken and pre- and postoperative visual acuity (VA), time until retinal repair, time until OCT, and type of surgery were analyzed. Results: The mean postoperative VA was 20/130. There was a positive linear relationship between pre- and postoperative VA. The average macular thickness was 254 ± 60 µ, and a strong positive correlation with postoperative logMAR VA was observed. Nineteen (49%) eyes exhibited pockets of subretinal fluid (SRF), 6 had foveal thinning, 5 had macular hole, and 1 each had foveal cyst, cystoid macular edema, and epiretinal membrane. Six patients had worse vision after surgery, 2 of whom had SRF on OCT, 2 foveal thinning, 1 mild macular thickening, and 1 normal image. Conclusion OCT images of various macular abnormalities may explain post-detachmentsurgery visual complaints. There was a positive correlation between pre- and postoperative VA, and an inverse correlation between macular thickness and postoperative VA.
Tomography ; Optical Coherence Visual Acuity Subretinal Fluid Vitrectomy Scleral Buckling

We investigated the surgical outcomes in 19 eyes with retinal detachment(RD)caused by macular hole only. 15 eyes were high-myopic(>-8.0Ds), and the mean preoperative axial-length was 28.30 mm. As an initial treatment method, simple gas injection was done to 2 eyes, and pars plana vitrecto-my(PPV), air-fluid exchange and subretinal fluid drainage with intravitreal tamponade were performed in 17 eyes. The retina of 2 eyes with simple gas injection was not attached because of persistent vitreoretinal traction. PPV with intravitreal tamponade was successful in 12 of 17 eyes with a single operation, and reoperation was effective in 3 eyes of the failed 5 eyes. We conclude that, in case of retinal detachment caused by macular hole, the success rate can be improved by PPV with complete removal of vitreoretinal traction along with the long-lasting intravitreal tamponade.
Drainage ; Humans ; Reoperation ; Retina ; Retinal Detachment* ; Retinal Perforations* ; Retinaldehyde* ; Subretinal Fluid ; Traction

The purpose of this work is to study the prevalence, causes and prognosis of late recurrences of retinal detachment after successful surgery.We reviewed 986 cases in 926 patients who had undergone surgery for primary retinal detachment.Late recurrence was defined as the reappearance of subretinal fluid 6 months or longer after complete retinal reattachment.We performed scleral buckling, cryopexy, or vitrectomy as the first operation. Twenty seven eyes in 25 patients (2.7%)had a late recurrence.New breaks were definitely identified in 11 eyes (40.8%), and 9 eyes had proliferative vitreoretinopathy.In 3 eyes, previous breaks were reopened.The causes of redetachment were not identified in 4 eyes.Most common cause of late recurrence of rhegmatogenous retinal detachment was the newly developed retinal breaks.So, It may be helpful in reducing the incidence of late recurrence to perform long-term careful fundus examination after successful first operation.
Humans ; Incidence ; Prevalence ; Prognosis ; Recurrence* ; Retinal Detachment* ; Retinaldehyde* ; Scleral Buckling ; Subretinal Fluid ; Vitrectomy

Result and complications were evaluated in 28 eyes of 28 patients who had undergone pneumatic retinopexy for rhegmatogenous retinal detachment from December 1994 to May 1995 and were followed for at least 4 months. Twenty four eyes were phakic, one eye aphakic and three eyes pseudophakic. 0.3mlof perfluoropropane(4 eyes)or 0.45ml of sulfur hexafluoride(24 eyes)was injected. Mean follow-up time was 33.3 months. Perioperative complications included subconjunctival gas in 2 eyes, subretinal gas in 1 eye and delayed absorption of subretinal fluid in 5 eyes. Retinal reattachment was obtained in 22 eyes(79%) and final reattachment rate was 100% with an additional procedure of scleral buckle(4 eyes)or pars plana vitrectomy(2 eyes). Final visual acuity improved in 25 eyes(89%), and decreased in 2 eyes. Postoperatively following complications were noted;mild proliferative vitreoretinopathy(3 eyes), epiretinal membrane(1 eye), central retinal artery occlusion(1 eye), nucleosclerosis(4 eyes)and cataract operation(2 eyes). This result suggests that pneumatic retinopexy could be a good method for the treatment of rhegmatogenous retinal detachment.
Absorption ; Cataract ; Follow-Up Studies ; Humans ; Retinal Artery ; Retinal Detachment ; Retinaldehyde ; Subretinal Fluid ; Sulfur ; Visual Acuity

Central serous chorioretinopathy is a disease which causes decreased visual acuity and functional disturbance. As the subretinal fluid is absorbed, the visual acuity is improved but patient's complaint such as metamorphosia is remained. To assess the recovery of visual functional disturbance in response to absorption of the fluid, the hue discrimination and contrast sensitivity were tested in central serous retinopathy patients (N=30) at the first visit, first visit after the absorption of subretinal fluid, and final visit. At the first visit, there were stastically significant differences in the mean square root of total error score, blue-yellow and red-green partial error score between normal control group and central serous retinopathy group and stastically significant differences in all spatial frequency between normal group and central serous retinopathy group. First visit after the absorption of subretinal fluid, and final visit, there were stastically significant differences in the mean square root of total error score, blue-yellow and red-green partial error score between normal control group and central serous retinopathy group and stastically significant differences in mid-high spatial frequency between normal group and central serous retinopathy group.
Absorption ; Central Serous Chorioretinopathy* ; Contrast Sensitivity* ; Discrimination (Psychology)* ; Humans ; Subretinal Fluid ; Visual Acuity

PURPOSE: The aim of this study was to evaluate the efficacy and potential value of fundus autofluorescence (FAF) in central serous chorioretinopathy (CSC). METHODS: FAF images were retrospectively evaluated in 122 eyes (119 patients) diagnosed with CSC by fluorescein angiography and OCT. Patients were classified into four groups (normal, mild, moderate, and intense) based on the intensity of FAF. We compared FAF patterns in acute and chronic-recurrent CSC and evaluated the differences in FAF according to the initial best corrected visual acuity (BCVA). We also assessed the differences in subretinal fluid resolution after laser photocoagulation among groups. RESULTS: In the chronic-recurrent group, a significant increase in FAF was observed compared to the acute group (p<0.001). The increase in initial visual acuity in the normal FAF group was statistically significant compared to the other groups (p<0.05). The difference in FAF between patients with acute and chronic-recurrent CSC was not significant. FAF imaging in CSC demonstrates different leakage patterns according to the course of the disease, but the changes in FAF did not correspond to the leakage patterns. In 51 eyes in the group without treatment and in 27 eyes of the focal treatment group, no significant difference was found in subretinal fluid resolution. CONCLUSIONS: FAF could be a non-invasive tool for monitoring RPE changes in central serous chorioretinopathy. FAF imaging could predict recent or former CSC episodes, and this information could be used to predict long-term visual acuity.
Central Serous Chorioretinopathy ; Eye ; Fluorescein Angiography ; Humans ; Light Coagulation ; Retrospective Studies ; Subretinal Fluid ; Visual Acuity