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*

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

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

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

Authors analysed clinically two groups(group A<40 years: 187 eyes, group B>40 years: 126 eyes) of 313 primary retinal detachment patients who have received operation and subsequent follow-up study for at least 3 months. The frequency by age was shown double peak at twenties and at fifties. Retinal dialysis and inferior temporal breaks in group A was shown more than those in group B, but superior temporal breaks was more occured in group B. The success rates of the first operation in group A were a little higher than those in group B. And in the case of successful eyes by the first operation, residual subretinal fluid were absorbed less than 1 day. Fish mouthing, glaucoma and chroidal detachment as intraoperative and postoperative complication occurred more frequently in group B. After the first operation, inadequate absorption of the subretinal fluid was more frequent in group B, recurrence of hole was more frequent in group A, but there's no statistical significance in above.
Absorption ; Dialysis ; Follow-Up Studies ; Glaucoma ; Humans ; Mouth ; Postoperative Complications ; Recurrence ; Retinal Detachment* ; Retinaldehyde* ; Subretinal Fluid

PURPOSE: We evaluated one patient with multiple evanescent white dot syndrome (MEWDS), using fundus fluorescein angiography (FAG), indocyanine green angiography (ICGA), optical coherence tomography (OCT) on acute phase of the disease, at 2 weeks after onset and at 10weeks. METHODS: Each diagnostic images were compared with patient's clinical course .OCT measurements of serial retinal thickness were done to assess the change in retinal thickness over the disease process. RESULTS: White dots on fundoscopic examination showed hypofluorescent on ICGA and imaged hyperreflective on OCT without presence of neither subretinal fluid nor neuroretinal increase in thickness. These ICGA and OCT findings suggest that lesions of perfusion defect on ICGA may be caused by interstitial precipitations of inflammatory cells in choriocapillaries and the underlying mechanism is not due to vasculitis with edema or serous exudation. CONCLUSIONS: ICGA and OCT allowed more precise anatomic evaluation than FAG in diagnosis and correlated well with clinical symptoms.
Angiography ; Diagnosis ; Edema ; Fluorescein Angiography ; Humans ; Indocyanine Green ; Perfusion ; Retinaldehyde ; Subretinal Fluid ; Tomography, Optical Coherence ; Vasculitis

We used 810 nm diode laser endophotocoagulator to perforate the choroid and retinal pigment epithelium for draining subretinal fluid during scleral buckling procedure. The laser settings reqiured for perforation ranged from 0.3 to 0.5 second of duration and from 300 to 500 mW of power. The average number of laser bums per site was 2.2 times(1-11times). Drainage was successful in all 42 rhegmatogenous retinal detachment patients treated. The complications associated with laser drainage included small subretinal hemorrhage in one eye(2.3%) and a faint laser bum on detached retina in one eye(2.3%). We believe that laser drainage is safe and requires no special skill.
Choroid ; Drainage* ; Hemorrhage ; Humans ; Lasers, Semiconductor* ; Retina ; Retinal Detachment ; Retinal Pigment Epithelium ; Scleral Buckling ; Subretinal Fluid*

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

Circumferential orientation of the buckle in desirable length may be preferable for closing the retinal breaks and the neighboring retinal degenerations. In contrast to radial buckling, according to Lincoff et al, the circumferential one is likely to lead to fishmouthing and radial folds; and the greater the buckle length, the more radial folds are anticipated. In this paper I summarized my opinions on these two problems pertaining to circumferential buckling; the method for preventing fishmouthing and diminishing radial folds on which the hole would impinge and leak posteriorly. A lamellar scleral undermining is performed on both sides of a single scleral incision which is parallel to the limbus and lccated on the equator. The undermining extends from the ora serrata to the region near the scleral entrance of the vortex veins (Fig. 2). The vortex veins are left intact. Surface diathermies are applied in the area undermined. Multiple penetrating diathermies are then applied in the undermined area near the retinal breaks to release subretinal fluid so that the detached retina of the breaks' area may sink on to the pigment epitheHum at first. Preserved sclera is used as an implant. The surface of the implant remains irregulary contoured. The width and the height of the implant depend upon the buckle desired (Fig. 1). After the implant is in place, the sutures are first tied in an area near the retinal breaks so that the radial folds move laterally from the retinal breaks. The surface of the buckles is somewhat irregular, which may compensate for redundant limbal parallel circumference of the detached retina (Fig. 3). The operation may be segmental or encircling. The circling band follows the globe's equator. 17 cases of ratinal detachments were treated with this technique; and in none of the above cases did the posterior edge of the break fishmouth or impinge upon a radial fold. The 100 percent final success in the small series of 17 cases in which an equatorial buckling was used at the initial surgery is also attributable to the relative lack of compiexity (excluding dialysis, giant tears, fixed retinal folds etc.) of cases. In my opinion, circumferential buckling on the equator utilizing a preserved sclera as an implant is convenient, sufficiently promising and carries less risk of reoperation.
Dialysis ; Diathermy ; Reoperation ; Retina ; Retinal Degeneration ; Retinal Perforations ; Retinaldehyde ; Sclera ; Subretinal Fluid ; Sutures ; Veins