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

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

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

BACKGROUNDAfter successful scleral buckle and cryotherapy for macular-off retinal detachment (RD), some patients have poor visual acuity without any clinically detected macular change, and the unsatisfactory postoperative visual acuity is difficult to explain. The purpose of this study was to determine the characteristics of subretinal fluid (SRF) after successful scleral buckle surgery for macula-off RD.

METHODSTwenty-eight eyes from 28 patients were included in this study. The patients underwent scleral buckle surgery combined with cryopexy for macular-off RD. After surgery, all eyes underwent thorough ophthalmologic examinations including slit-lamp biomicroscopy, best-corrected visual acuity (BCVA) test, and binocular indirect ophthalmoscopy. The BCVA prior to the operation, duration of RD, the duration of postoperative retinal reattachment, BCVA when SRF was observed, period required for the SRF to become undetectable, and the BCVA at the final follow-up were included in the clinical data for this study. Optical coherence tomography (OCT) and B-ultrasonography were used to confirm SRF, and fluorescein angiography (FFA) was carried out in several patients. BCVA when SRF was observed and BCVA at the final follow-up were evaluated using a paired t test. Correlations between BCVA before the operation and duration of RD and BCVA at the final follow-up were analyzed using the Pearson correlation test. The type of SRF under OCT and BCVA at the final follow-up were compared using one-way analysis of variance (ANOVA).

RESULTSPostoperative retinal reattachment was achieved in 1.0 - 7.0 days (average, (2.7 ± 2.1) days). After retinal reattachment, SRF was detected in all eyes by OCT 2 weeks postoperative, while B ultrasonography found no changes. The mean logMAR BCVA was 0.35 ± 0.27 at the time of the detection of SRF. The period for SRF to become undetectable ranged from 2.0 to 11.0 months (average, (6.3 ± 2.3) months). The time of follow-up ranged from 24.0 to 36.0 months (average, (28.9 ± 3.4) months). The mean logMAR BCVA improved to 0.30 ± 0.23 at the final follow-up, which was significantly different from the mean logMAR BCVA at the time of SRF detection (paired t-test, t = 3.82, P < 0.05). Postoperative OCT images were classified into three categories. FFA was carried out in 10 eyes and revealed no leakage or strain in the lesions. BCVA before the operation was significantly correlated with BCVA at the final follow-up (r = 0.56, P < 0.05). No significant correlation was observed between BCVA at the final follow-up and duration of RD (r = 0.23, P = 0.22). One-way analysis of variance (ANOVA) showed no significant difference between the type of SRF under OCT and BCVA at the final follow-up (F = 0.21, P = 0.81).

CONCLUSIONSThe presence of persistent SRF after successful scleral buckle surgery for macular-off rhegmatogenous RD may influence the BCVA or anatomic attachment. SRF was detected in all eyes by OCT at 2 weeks after the operation. Residual detachment persisted for almost a year after surgery in certain patients. Fluorescein angiography revealed no leakage or strain in the lesions.

Adult ; Female ; Humans ; Male ; Retinal Detachment ; surgery ; Scleral Buckling ; adverse effects ; Subretinal Fluid ; secretion ; Young Adult

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

PURPOSE: To report a case of serous macular detachment preceding macular retinoschisis in an optic pit patient successfully treated by vitrectomy with internal limiting membrane peeling. CASE SUMMARY: A 76 year old female visited our clinic for visual disturbance in her right eye. Fundus photograph revealed optic pit and OCT showed macular retinoschisis in her right eye. She was followed up in our clinic. The patient revisited our clinic because of sudden decrease of visual acuity in her right eye 3 days before. At that time, the patient's best-corrected visual acuity was 0.05. Macular retinoschisis, subretinal fluid and serous retinal detachment were observed in her right eye on OCT. She was diagnosed with serous retinal detachment associated with optic pit and pars plana vitrectomy was performed. During vitrectomy, we found adhesion and defect of posterior hyaloid membrane which covered the optic pit. Therefore, subretinal fluid was drained via membrane defect and posterior vitreous detachment and fluid-gas exchange were induced. Sixteen days after surgery, we found a macular hole in her right eye on OCT. Pars plana vitrectomy was performed with internal limiting membrane peeling. One month after surgery, macular detachment was not observed. Six months after surgery, the patient's best corrected visual acuity was 0.63 and the macula was reattached completely. CONCLUSIONS: Optic pit maculopathy can be progressed rapidly in aged patients and macular hole would be ocurred as a complication. Additional study will be needed to figure out the role of internal limiting membrane and tractional force of posterior vitreous in these patients.
Female ; Humans ; Membranes ; Retinal Detachment ; Retinal Perforations ; Retinoschisis* ; Subretinal Fluid ; Traction ; Visual Acuity ; Vitrectomy ; Vitreous Detachment