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*

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

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

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

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

PURPOSE: To determine the efficacy of using the preferential hyperacuity perimeter (PHP) for the analysis of metamorphopsia following macular-off rhegmatogenous retinal detachment (RRD) surgical repair. METHODS: PHP examination was performed in those who complained of metamorphopsia after successful surgical reattachment of RRD. The subjective symptoms were evaluated based on a scale, ranging from 0 to 10, and were compared with the results of PHP examination. Patients age, duration of retinal detachment, pre and post-operative visual acuity, postoperative presence of subretinal fluid (SRF), surgical methods, presence of epiretinal membrane, and time from operation to PHP test were analyzed to find the correlation with the PHP results. RESULTS: Of the 19 eyes included in this study, nine eyes were found to have a hyperacuity defect upon PHP examination. In this group, the subjective level of metamorphopsia was significantly worse (p<0.01), the age was significantly higher (p=0.02), and SRF persisted in the macula more frequently at two months postoperatively (p=0.04), as compared to those without the defect. There were no significant differences in the other factors. CONCLUSIONS: Subjectively severe metamorphopsia after surgery for RRD could be confirmed objectively using PHP. In the case of older patients and persistent submacular fluid, metamorphopsia would develop more frequently due to displacement of the photoreceptors in the process of reattachment.
Displacement (Psychology) ; Epiretinal Membrane ; Eye ; Humans ; Retinal Detachment ; Subretinal Fluid ; Vision Disorders ; Visual Acuity

PURPOSE: To report a case of bilateral central serous chorioretinopathy (CSC) after blunt trauma with rapid remission. CASE SUMMARY: A 44-year-old man visited our clinic after blunt trauma around the right eye. At the first examination, no ocular problem was detected except a periorbital contusion. After one week, the patient complained of visual disturbance in his right eye. Fundus examination showed subretinal fluid in his right eye, and fluorescein angiography (FAG) showed typical smoke-stack pattern leakage, which lead to a diagnosis of CSC. Three days later, the patient complained of visual disturbance in his left eye, which was then also diagnosed as CSC. After 2 more weeks, the subretinal fluid in the right and left eyes had decreased. After 3 weeks, the subretinal fluid was almost completely absorbed in both eyes. CONCLUSIONS: Central serous chorioretinopathy can develop after blunt trauma, especially with a rapid clinical course. Thus, periodic ophthalmologic examination is needed after the first examination for blunt trauma of the eye.
Adult ; Central Serous Chorioretinopathy* ; Contusions ; Diagnosis ; Fluorescein Angiography ; Humans ; Subretinal Fluid

With some modification of buckling technique, a distinct improvement in success rate of retinal detachment surgery was achieved. Retinal detachment surgery was performed by following procedures. Perforation for the release of subretinal fluid was done in the vicinity of the retinal breaks so that the detached retina of this area can be settled on the underlying choroid. After implant was in place, sutures were tied down over the breaks so that radial retinal folds move aside from the retinal breaks. And irregular bulging of the buckle which compensates for redundant limbal circumference of the detached retina was created by additional mattress sutures over the breaks and the end of sponge. The success rate of the first retinal detachment surgery with episcleral silicone sponge was 93.7%. The success rate of long circumferential buckling was 94.3%, and that of short circumferential buckling was 92.3%. There were no significant difference betweem two buckling procedures. We also made comparison with intrascleral preserved sclera implant technique of our previous series(success rate of 92.8%). There was no difference between the two in success rate.
Choroid ; Porifera* ; Retina ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Sclera ; Silicones* ; Subretinal Fluid ; Sutures

Central serous chorioretinopathy(CSC) is a retinal disorder that typically affects young and middle-aged adults. It is characterized by the accumulation of subretinal fluid at the posterior pole of the fundus, causing a circumscribed area of retinal detachment. It is essentially benign and self-limited, generally requiring no treatment. However, a few patients have permanent visual loss because of subretinal fibrosis following a nonrhegmatogenous, bullous retinal detachment with shifting subretinal fluid. The authors experienced a case of CSC with bilateral bullous retinal detachment in a 36 year old male patient. A subretinal fibrotic band developed in both maculae and permanent visual loss of both eyes occurred. We report this unusual case with literature review.
Adult ; Central Serous Chorioretinopathy* ; Fibrosis ; Humans ; Male ; Retinal Detachment* ; Retinaldehyde* ; Subretinal Fluid