Persistent subretinal fluid following diabetic tractional retinal detachment repair: risk factors, natural history, and
- PDF / 1,379,439 Bytes
- 12 Pages / 547.087 x 737.008 pts Page_size
- 3 Downloads / 168 Views
(0123456789().,-volV) ( 01234567 89().,-volV)
ORIGINAL PAPER
Persistent subretinal fluid following diabetic tractional retinal detachment repair: risk factors, natural history, and management outcomes Ahmed Algethami . Mohammed Talea . Wael A. Alsakran . Marco Mura . Sulaiman M. Alsulaiman
Received: 16 November 2019 / Accepted: 30 September 2020 Ó Springer Nature B.V. 2020
Abstract Purpose To study the natural history, anatomical and functional outcomes of persistent subretinal fluid (SRF) after pars plana vitrectomy (PPV) for diabetic tractional retinal detachment (TRD) and combined traction-rhegmatogenous retinal detachment (TRRD). Methods Retrospective interventional case series of 43 patients (46 eyes) with persistent SRF following PPV for diabetic TRD or combined TRRD from January 2010 to December 2017 at single tertiary institution. Primary outcomes included best corrected visual acuity (BCVA) and central foveal thickness (CFT). Results Thirty-one eyes (67.4%) had macula-off TRD, 5 (10.9%) had fovea-threatening TRD and 10 (21.7%) had combined TRRD. The mean (± SD) duration of decreased vision was 48.0 ± 58.2 weeks. The mean follow-up duration was 21 ± 13.2 months. Residual macular SRF was detected by optical coherence tomography in all eyes at 3 months and in 10 eyes (23.8%) at 12 months after surgery. Only 3 eyes (6.5%) had persistent SRF at final follow up. The mean time to resolution was 10.6 ± 4.1 months [range 6.0–23.0]. Thirteen eyes received additional intervention to address SRF. The mean CFT gradually
A. Algethami M. Talea W. A. Alsakran M. Mura S. M. Alsulaiman (&) Vitreoretinal Division, King Khaled Eye Specialist Hospital, P.O. Box 7191, Riyadh 11462, Saudi Arabia e-mail: [email protected]
improved until final follow-up (P-value \ 0.001). The mean BCVA improved from 1.62 ± 0.88 LogMAR at presentation to 1.05 ± 0.76 LogMAR at final follow up. No statistically significant difference in final BCVA was found between eyes that had intervention and eyes that were observed (P value = 0.762). Conclusion Persistent SRF after diabetic vitrectomy resolves slowly over time with gradual improvement in visual acuity. Additional drainage of persistent SRF may not be necessary. Keywords Diabetic pars plana vitrectomy Diabetic tractional detachment Combined tractionalrhegmatogenous detachment Subretinal fluid Submacular fluid
Introduction Tractional complications of advanced proliferative diabetic retinopathy remain a major indication for vitrectomy [1–10]. Surgery for tractional retinal detachment (TRD) and traction-rhegmatogenous retinal detachment TRRD has variable visual outcomes and several prognostic factors come into play. The main prognostic factors include chronicity of the macular detachment, photoreceptor layer integrity and macular perfusion status [9, 11–19]. In a subset of
123
Int Ophthalmol
patients following successful vitrectomy for TRD or TRRD, a residual submacular fluid is sometimes noted. This is a well-known finding after scleral buckle surgery and to a lesser exten
Data Loading...
