Selective retina therapy (SRT) of chronic subfoveal fluid after surgery of rhegmatogenous retinal detachment: three case reports.
BACKGROUND
Shallow subfoveal fluid accumulation after successful surgery for retinal detachment can be the reason for compromised visual acuity. To date, therapeutical options to tackle this problem have not been established. Selective retina therapy (SRT) is a new laser technology that uses a train of mus-laser pulses to selectively damage retinal pigment epithelial (RPE) cells while sparing retinal structures.


METHODS
We treated three patients with chronic subfoveal fluid accumulation after retinal detachment surgery. The median period between retinal surgery and SRT treatment was 7 months. For SRT, we used a prototype frequency-doubled, Q-switched Nd:YLF laser (lambda = 527 nm). Each laser exposition contained 30 pulses (t = 1,7 micros, 100 Hz, E = 100-400 microJ). Two of the three patients were treated subfoveally. OCT III (optical coherence tomography) examinations were performed to evaluate changes in subretinal fluid accumulation.


RESULTS
In all three patients, we observed complete resolution of subfoveal fluid within 1-5 months. Follow-up has been 16 months to 2 years. Visual acuity improved in all patients. In one patient, cystoid macular edema developed 3 months after treatment. Additional SRT treatments were not necessary.


CONCLUSIONS
SRT is a safe treatment. Visual acuity improved after SRT, even in subfoveal irradiations. SRT is an option to support subretinal fluid reabsorption. In this situation where no other therapeutical options are established, SRT may be a beneficial treatment for chronic subfoveal fluid accumulation after retinal detachment surgery.
Department of Ophthalmology, University Hospital of Schleswig-Holstein, Campus Kiel, Hegewischstr.2, 24105 Kiel, Germany. koinzer@ophthalmol.uni-kiel.de
Stefan
S
Koinzer
Hanno
H
Elsner
Carsten
C
Klatt
Erk
E
Pörksen
Ralf
R
Brinkmann
Reginald
R
Birngruber
Johann
J
Roider
D000328:Adult; D000368:Aged; D001826:Body Fluids / Q000378:metabolism*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D028022:Low-Level Light Therapy / Q000379:methods*; D008297:Male; D011183:Postoperative Complications; D012163:Retinal Detachment / Q000601:surgery*; D055213:Retinal Pigment Epithelium / Q000378:metabolism / Q000601:surgery*; D012189:Retrospective Studies; D012591:Scleral Buckling; D041623:Tomography, Optical Coherence; D014792:Visual Acuity