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Abstract Persistent subretinal fluid (PSF) after scleral bucking of rhegmatogenous retinal detachment may delay recovery and affect the final visual quality, but with no effective treatment. This study firstly investigated the safety and efficacy of 577 nm yellow subthreshold micropulse laser (SML) on PSF after scleral bucking surgery. This double-masked randomized clinical trial was conducted from December 2020 to October 2022 at Chongqing Aier Eye Hospital. Participants with PSF last for 1 month after scleral bucking surgery with break closed and retina reattachment were recruitment. These participants were treated by 577 nm yellow SML or sham treatment. Funduscopy, optical coherence tomography (OCT) volume change, best corrected vision acuity (BCVA) and visual field test were evaluated for six mouths follow-up. A total of 24 participants were randomized into SML group or Sham group equally. Compared with Sham group, the OCT volume within 6 mm of macular fovea was significantly less in SML group 6 months after therapy (P = 0.048). There were no statistically significant differences of OCT volume at 1, 2 and 3 months from baseline between groups. BCVA of ETDRS letters had no statistically significant difference. Pattern Standard Deviation amelioration (P = 0.039) had statistically significance in SML group compared with Sham group. There were no complications in the 2 groups. These preliminary findings suggest that 577 nm yellow SML therapy could accelerate PSF absorption after scleral bucking surgery. Trial registration: Chinese Clinical Trial Registry No. ChiCTR2000037838, 02/09/2020, https://www.chictr.org.cn/showproj.html?proj=51885 .

Persistent subretinal fluid (PSF) after scleral bucking of rhegmatogenous retinal detachment may delay recovery and affect the final visual quality, but with no effective treatment. This study firstly investigated the safety and efficacy of 577 nm yellow subthreshold micropulse laser (SML) on PSF after scleral bucking surgery. This double-masked randomized clinical trial was conducted from December 2020 to October 2022 at Chongqing Aier Eye Hospital. Participants with PSF last for 1 month after scleral bucking surgery with break closed and retina reattachment were recruitment. These participants were treated by 577 nm yellow SML or sham treatment. Funduscopy, optical coherence tomography (OCT) volume change, best corrected vision acuity (BCVA) and visual field test were evaluated for six mouths follow-up. A total of 24 participants were randomized into SML group or Sham group equally. Compared with Sham group, the OCT volume within 6 mm of macular fovea was significantly less in SML group 6 months after therapy (P = 0.048). There were no statistically significant differences of OCT volume at 1, 2 and 3 months from baseline between groups. BCVA of ETDRS letters had no statistically significant difference. Pattern Standard Deviation amelioration (P = 0.039) had statistically significance in SML group compared with Sham group. There were no complications in the 2 groups. These preliminary findings suggest that 577 nm yellow SML therapy could accelerate PSF absorption after scleral bucking surgery. Trial registration: Chinese Clinical Trial Registry No. ChiCTR2000037838, 02/09/2020, https://www.chictr.org.cn/showproj.html?proj=51885. [ABSTRACT FROM AUTHOR]

Persistent subretinal fluid (PSF) is a condition in which fluid is observed in the subretinal area in optical coherence tomography despite the retina being attached to the retina after rhegmatogenous retinal detachment (RRD) surgery. It is reported that it mostly regresses spontaneously in one-year follow-up and has no effect on the final visual acuity. In this report, we present a case of PSF who developed after successful RRD surgery, in which, contrary to the general belief, subretinal fluid persisted and visual acuity was low at the 15th month follow-up despite the early postoperative treatments. The aim of this article is to consider PSF as a complication in patients with low visual acuity after successful RRD surgeries. [ABSTRACT FROM AUTHOR]

AIM: To evaluate visual outcomes and changes in fluid after administering monthly anti-vascular endothelial growth factor (VEGF) injections to treat neovascular age-related macular degeneration (nAMD) with subretinal fluid (SRF) and pigment epithelial detachment (PED). METHODS: This prospective study included eyes with nAMD previously treated with as-needed anti-VEGF injections. The patients were treated with six monthly intravitreal injections of ranibizumab. Quantitative volumetric segmentation analyses of the SRF and PED were performed. The main outcome measures included best-corrected visual acuity (BCVA), and SRF and PED volumes. RESULTS: Twenty eyes of 20 patients were included in this study. At the 6-month follow-up, BCVA and PED volume did not change significantly (P=0.110 and 0.999, respectively) but the mean SRF volume decreased from 0.53±0.82 mm3 at baseline to 0.08±0.23 mm3 (P=0.002). The absorption rate of the SRF volume was negatively correlated with the duration of previous anti-VEGF treatment (P=0.029). Seven of the 20 eyes (35%) showed a fluid-free macula and significant improvement in BCVA (P=0.036) by month 6. CONCLUSION: Quantifying the SRF can precisely determine the patient's responsiveness to anti-VEGF treatment of nAMD.

Purpose: To evaluate whether choroidal thickness (CT) is associated with persistent subretinal fluid (pSRF) after simple primary rhegmatogenous retinal detachment (RRD) repair. Methods: This single‐centre, retrospective, observational study included patients who underwent RRD repair with at least 12‐month follow‐up. Preoperative and postoperative parameters were evaluated for association with pSRF. CT measurements were obtained at the central 1 mm area on enhanced depth imaging (EDI) OCT scans, using a semiautomatic method. Multiple logistic regression analyses were assessed to determine predictive factors for pSRF. Results: Overall, 100 eyes of 100 patients, mean age of 59.9 ± 12.6 years were included. pSRF was found in 21.0% of eyes and resolved over time in 85.7% of eyes at 12 months. In the pSRF group both RRD and fellow eyes showed lower mean choroidal and RPE thickness values as compared to those without pSRF (p < 0.05). A significant correlation was found between pSRF occurrence and choroidal thinning (p = 0.02). After multiple regression analyses, macula‐off RRD (p = 0.005) and scleral buckling (SB) technique (p = 0.001) were retained as final predictors for pSRF. In macula‐off SB eyes, detachment duration was the only factor associated with pSRF (p = 0.046). There were no significant differences in best‐corrected visual acuity outcomes between the pSRF and the no‐pSRF eyes. Conclusions: Patients with pSRF showed lower choroidal and RPE thickness as compared to those without pSRF. CT did not turn out to be a final predictor for pSRF, as this was mainly associated with macular involvement, surgical technique and detachment duration. [ABSTRACT FROM AUTHOR]

Purpose: To illustrate different scenarios of minimal persistent subretinal fluid (PSRF) after pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) Methods: In our retrospective case series we recorded age, Best-corrected visual acuity (BCVA), spherical equivalent, fundus examination pre- and post-operatively as well as serial Optical coherence tomography (OCT) to follow up PSRF. Results: All eyes showed gradual decrease in PSRF for up to one year in some cases, as demonstrated by OCT. BCVA improved significantly at total subsidence of the PSRF compared to early postoperative BCVA. Conclusion: PSRF can delay visual recovery after PPV for RRD for up to one year postoperatively but still resorb spontaneously even in high myopes, upper retinal tear, lower PSRF or even following removal of Silicon oil tamponade. It is thus plausible to avoid hazardous early surgical drainage with close monitoring to exclude open retinal breaks or evident traction that necessitate drainage. [ABSTRACT FROM AUTHOR]

Barsha Suwal,1 Deepak Khadka,1 Arjun Shrestha,1 Sangeeta Shrestha,1 Nirsara Shrestha,1 Bijay Khatri2 1Department of Ophthalmology, BP Eye Foundation, Hospital for Children, Eye, ENT and Rehabilitation Services (CHEERS), Lokanthali, Bhaktapur, Nepal; 2Department of Academics and Research, Hospital for Children, Eye, ENT, Rehabilitation Services (CHEERS), Lokanthali, Bhaktapur, NepalCorrespondence: Barsha SuwalDepartment of Ophthalmology, BP Eye Foundation, Hospital for Children, Eye, ENT and Rehabilitation Services (CHEERS), Lokanthali, Bhaktapur, NepalTel +977-9803056313Fax +977-16639735 Email suwal.barsha@gmail.comBackground: To determine the influence of spectral domain optical coherence tomography (OCT) changes on visual outcome and persistence of subretinal fluid (SRF) in patients with idiopathic central serous chorioretinopathy (CSCR).Materials and methods: In a retrospective study done in 48 eyes of 45 patients diagnosed as CSCR, all eyes were subjected to fundus photography, spectral domain OCT, and fluorescein angiography (FA) in selected cases.Results: Retinal pigment epithelium detachment was present in 22.91% of the cases at presentation. The logMar best corrected visual acuity improved from 0.46±0.29 at presentation to 0.18±0.22 at 3 months (P-value0.3 logMar) were disruption in the inner segment (IS)/outer segment (OS) junction or external limiting membrane (ELM) line and hyper-reflective dots in the intra/subretinal layer (P-value

Delayed absorption of limited subretinal fluid occurs in some patients with rhegmatogenous retinal detachment(RRD)after scleral buckling. The macular-off patients may be effected more on visual function. The progress of recent researches on the epidemiology, diagnosis, pathogenesis and treatment of persistent subretinal fluid with rhegmatogenous retinal detachment has been summarized in this article.

Persistent subretinal fluid (SRF) may occur even after successful surgery for rhegmatogenous retinal detachment (RRD). In most cases, persistent SRF resolves spontaneously within a year, but persistent SRF may cause poor central vision, photoreceptor damage, and the irreversible loss of visual function. Therefore, a variety of interventions have been developed to manage persistent SRF, including the prophylactic use of steroids. As far as we know, an intravitreal steroid injection has never been used in the treatment of persistent SR. This report is a description of steroid treatment used in the case of a 46-year-old male patient with SRF persisting for 15 months after pars plana vitrectomy surgery for the treatment of macula-off RRD. A single-dose intravitreal triamcinolone acetonide (IVTA) injection (4 mg/0.1 mL) was administered; however, no improvement was seen in the lesions. It was concluded that an IVTA injection should be used in a limited fashion in patients with persistent SRF.

Aim: To evaluate visual outcomes and changes in fluid after administering monthly anti-vascular endothelial growth factor (VEGF) injections to treat neovascular age-related macular degeneration (nAMD) with subretinal fluid (SRF) and pigment epithelial detachment (PED)., Methods: This prospective study included eyes with nAMD previously treated with as-needed anti-VEGF injections. The patients were treated with six monthly intravitreal injections of ranibizumab. Quantitative volumetric segmentation analyses of the SRF and PED were performed. The main outcome measures included best-corrected visual acuity (BCVA), and SRF and PED volumes., Results: Twenty eyes of 20 patients were included in this study. At the 6-month follow-up, BCVA and PED volume did not change significantly ( P =0.110 and 0.999, respectively) but the mean SRF volume decreased from 0.53±0.82 mm 3 at baseline to 0.08±0.23 mm 3 ( P =0.002). The absorption rate of the SRF volume was negatively correlated with the duration of previous anti-VEGF treatment ( P =0.029). Seven of the 20 eyes (35%) showed a fluid-free macula and significant improvement in BCVA ( P =0.036) by month 6., Conclusion: Quantifying the SRF can precisely determine the patient's responsiveness to anti-VEGF treatment of nAMD., (International Journal of Ophthalmology Press.)

Purpose: To evaluate the role of en face OCT as a diagnostic tool for the detection of persistent subretinal fluid (PSRF) and outer retinal folds (ORFs) after successful rhegmatogenous retinal detachment (RRD) repair., Design: Observational post hoc analysis of 2 prospective surgical trials., Participants: All patients with gradable (signal strength ≥ 5 and no segmentation error) 6 × 6-mm 2 macular cube scans obtained using spectral-domain OCT (Carl Zeiss Meditec) between 1 and 2 months after surgery were included in this study., Methods: The scans were assessed for the presence or absence of PSRF or ORFs using en face OCT and cross-sectional B scans by 2 masked graders, with any disagreements adjudicated by a third senior masked grader., Main Outcome Measures: The sensitivity, specificity, and predictive accuracy (using area under the curve [AUC]) of en face OCT were compared with those of cross-sectional OCT, which is considered the gold standard., Results: Two hundred twenty-three patients were included in this study. The Cohen kappa between the graders in the diagnosis of PSRF and ORFs using en face OCT was 0.84 and 0.86, respectively. The sensitivity of en face OCT was 100% (95% confidence interval [CI], 100%-100%) in the diagnosis of PSRF and 98.8% (95% CI, 96.5%-101.1%) in the diagnosis of ORFs. Similarly, the specificity of en face OCT was 98.7% (95% CI, 96.8%-100.5%) and 84.2% (95% CI, 78.1%-90.2%) in the diagnosis of PSRF and ORFs, respectively. The AUC was 0.99 for PSRF and 0.91 for ORFs., Conclusions: En face OCT has good sensitivity, specificity, and predictive accuracy (using AUC) in the diagnosis of PSRF and ORFs. En face OCT is an efficient screening tool for postoperative anatomic abnormalities, such as PSRF and ORFs, after RRD repair., Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article., (Copyright © 2023 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Purpose: To provide an updated, critical summary of the literature on the topic of persistent subretinal fluid (PSF) following successful rhegmatogenous retinal detachment surgery., Methods: Narrative literature review., Results: PSF remains an insufficiently studied topic. Incidence rates vary significantly between reports, but pars plana vitrectomy seems associated with lower rates than buckle surgery. Multiple etiologies and risk factors have been proposed, none being conclusive. PSF gradually resolves in most cases which may be a lengthy process, often with no effect on potential final visual acuity. There is concern that some cases with PSF may sustain photoreceptor damage, retinal displacement, or retinal fold formation. There is no current evidence to support any treatment modality over observation in uncomplicated cases of PSF., Conclusion: Future large, well-controlled, prospective trials could help elucidate incidence rate, etiological factors, and sequelae of PSF, as well as the value of different interventions in its prevention and management.

Background: Persistent subretinal fluid after rhegmatogenous retinal detachment (RRD) surgery is responsible for delayed recovery, and may affect the final visual outcome. Cause, consequences, and treatment remain elusive. Design: Literature review and case series. Methods: We reviewed the pathophysiological principles and therapeutic options from the literature, and we report the results from a subretinal fluid cytology study. Nine eyes from nine patients with macula-involving RRD underwent surgical repair. The cellular content of subretinal fluid (SRF) was studied by electron microscopy and anti-rhodopsin immunostaining. All eyes were assessed postoperatively with optical coherence tomography for the detection of persistent submacular fluid (PSF) (Ethics Committee Ghent University Hospital, registration number B6702006169). Results: Certain patient characteristics as well as surgical methods were implicated. PSF appears to occur more frequently in patients with longstanding detachments treated with buckling surgery. Several therapeutic options have been suggested but safety and efficacy remain unclear. We found PSF in three eyes on postoperative OCT scans, which corresponded to the three cell-rich subretinal samples. Conclusions: PSF after successful RRD repair seems to be related to fluid composition. We hypothesize, in the absence of an effective treatment, that a modified surgical drainage, including a washout of the subretinal space, could evacuate the subretinal fluid more completely, and may prevent this complication. [ABSTRACT FROM AUTHOR]

(1) Background: We analyzed the duration of persistent subretinal fluid (PSF) and the contributing factors of PSF after pars plana vitrectomy in patients who had a macula with diabetic tractional retinal detachment (TRD). (2) Methods: Forty eyes of 40 patients who had pars plana vitrectomy due to a macula with diabetic TRD, between 2014 and 2020, were retrospectively reviewed. The duration of PSF, as well as relevant ocular and systemic factors, was analyzed. (3) Results: The mean duration of PSF was 4.4 ± 4.7 months. The prevalence of PSF was 75.0% at 1 month, 50.0% at 3 months, 30.0% at 6 months and 10.0% at 12 months after surgery. Blood urea nitrogen, creatinine, and estimated glomerular filtration rate (eGFR) were significantly associated with the duration of PSF in the univariate analysis. In the multivariate analysis, only eGFR was significantly associated with the duration of PSF (β = −0.089, p = 0.030). (4) Conclusion: PSF may persist for more than 12 months in a macula with diabetic TRD after vitrectomy. Moreover, patients with impaired kidney function tended to have a delayed subretinal fluid absorption. Therefore, careful investigation of preoperative systemic conditions, especially kidney function, should be considered before TRD surgery in diabetic patients. [ABSTRACT FROM AUTHOR]