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Persistent subretinal fluid after surgery for rhegmatogenous retinal detachment: hypothesis and review

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Abstract
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. Literature review and case series. 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). 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. 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.
Keywords
Subretinal fluid composition, Rhegmatogenous retinal detachment, Persistent subretinal fluid, Photoreceptors, OPTICAL COHERENCE TOMOGRAPHY, SCLERAL BUCKLE SURGERY, RANDOMIZED CLINICAL-TRIAL, PIGMENT-EPITHELIUM, PRIMARY VITRECTOMY, SUBMACULAR FLUID, SUBFOVEAL FLUID, VISUAL RECOVERY, MACULAR EDEMA, LESIONS

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MLA
Veckeneer, Marc, Lara Derycke, EW Lindstedt, et al. “Persistent Subretinal Fluid After Surgery for Rhegmatogenous Retinal Detachment: Hypothesis and Review.” GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY 250.6 (2012): 795–802. Print.
APA
Veckeneer, M., Derycke, L., Lindstedt, E., van Meurs, J., Cornelissen, M., Bracke, M., & Van Aken, E. (2012). Persistent subretinal fluid after surgery for rhegmatogenous retinal detachment: hypothesis and review. GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY, 250(6), 795–802.
Chicago author-date
Veckeneer, Marc, Lara Derycke, EW Lindstedt, J van Meurs, Maria Cornelissen, Marc Bracke, and Elisabeth Van Aken. 2012. “Persistent Subretinal Fluid After Surgery for Rhegmatogenous Retinal Detachment: Hypothesis and Review.” Graefes Archive for Clinical and Experimental Ophthalmology 250 (6): 795–802.
Chicago author-date (all authors)
Veckeneer, Marc, Lara Derycke, EW Lindstedt, J van Meurs, Maria Cornelissen, Marc Bracke, and Elisabeth Van Aken. 2012. “Persistent Subretinal Fluid After Surgery for Rhegmatogenous Retinal Detachment: Hypothesis and Review.” Graefes Archive for Clinical and Experimental Ophthalmology 250 (6): 795–802.
Vancouver
1.
Veckeneer M, Derycke L, Lindstedt E, van Meurs J, Cornelissen M, Bracke M, et al. Persistent subretinal fluid after surgery for rhegmatogenous retinal detachment: hypothesis and review. GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY. 2012;250(6):795–802.
IEEE
[1]
M. Veckeneer et al., “Persistent subretinal fluid after surgery for rhegmatogenous retinal detachment: hypothesis and review,” GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY, vol. 250, no. 6, pp. 795–802, 2012.
@article{2116371,
  abstract     = {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. 
Literature review and case series. 
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). 
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. 
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.},
  author       = {Veckeneer, Marc and Derycke, Lara and Lindstedt, EW and van Meurs, J and Cornelissen, Maria and Bracke, Marc and Van Aken, Elisabeth},
  issn         = {0721-832X},
  journal      = {GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY},
  keywords     = {Subretinal fluid composition,Rhegmatogenous retinal detachment,Persistent subretinal fluid,Photoreceptors,OPTICAL COHERENCE TOMOGRAPHY,SCLERAL BUCKLE SURGERY,RANDOMIZED CLINICAL-TRIAL,PIGMENT-EPITHELIUM,PRIMARY VITRECTOMY,SUBMACULAR FLUID,SUBFOVEAL FLUID,VISUAL RECOVERY,MACULAR EDEMA,LESIONS},
  language     = {eng},
  number       = {6},
  pages        = {795--802},
  title        = {Persistent subretinal fluid after surgery for rhegmatogenous retinal detachment: hypothesis and review},
  url          = {http://dx.doi.org/10.1007/s00417-011-1870-y},
  volume       = {250},
  year         = {2012},
}

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