title: Spectral-domain optical coherence tomography analysis of persistent subretinal fluid after scleral buckling surgery for macula-off retinal detachment.
abstract: OBJECTIVE
  To determine the predictive value of markers for persistent subretinal fluid (SRF) absorption and the influence of subfoveal fluid on visual outcome after scleral buckle (SB) surgery for rhegmatogenous retinal detachment (RRD).
  
  
  METHODS
  This was a retrospective, observational study. We reviewed the medical records of 64 eyes of 64 patients who underwent SB surgery for macula-off RRD. Patients underwent clinical examination and spectral-domain optical coherence tomography before surgery, at 1 month and every 3 months postoperatively. The height and width of SRF bleb(s) were measured over time.
  
  
  RESULTS
  Persistent SRF at 1 month was observed in 40 eyes (62.5%). SRF blebs were first detected 1.7 ± 2.2 months postoperatively. In 29 cases that could be fully followed up, SRF blebs were completely absorbed 7.8 ± 4.4 months postoperatively. Resolution of fluid was associated with an improvement of VA (P = 0.003). Serial measurements of SRF bleb size showed that bleb width decreased significantly at all time points during the 12-month follow-up period (P < 0.05), while significant bleb height decrease occurred from postoperative sixth month only (P < 0.05). There was no correlation between VA outcomes and subfoveal bleb height or width (P > 0.05). The cut-off value of the bleb width-to-height ratio level for predicting bleb absorption at 6 months was 7, with 89% sensitivity and 83% specificity.
  
  
  CONCLUSIONS
  Visual improvement may occur with late resolution of residual subfoveal fluid. A bleb width-to-height ratio >7 indicates a higher risk of SRF to persist beyond 6 months after surgery.
authors.affiliation: Department of Ophthalmology, Sapienza University, Umberto I Hospital, Rome, Italy.
authors.forename: M
authors.identifier: http://orcid.org/0000-0002-4991-9689
authors.initials: M
authors.lastname: Gharbiya
authors.affiliation: Department of Ophthalmology, Sapienza University, Umberto I Hospital, Rome, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Malagola
authors.affiliation: Department of Ophthalmology, Polytechnic University of Marche, Ancona, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Mariotti
authors.affiliation: Department of Ophthalmology, Sapienza University, Umberto I Hospital, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Parisi
authors.affiliation: Department of Ophthalmology, Sapienza University, Umberto I Hospital, Rome, Italy.
authors.forename: U
authors.initials: U
authors.lastname: De Vico
authors.affiliation: Department of Ophthalmology, Sapienza University, Umberto I Hospital, Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Ganino
authors.affiliation: Department of Ophthalmology, Sapienza University, Umberto I Hospital, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Grandinetti
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D005260:Female; D006801:Humans; D008266:Macula Lutea / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology; D011237:Predictive Value of Tests; D012163:Retinal Detachment / Q000601:surgery*; D012189:Retrospective Studies; D012591:Scleral Buckling / Q000009:adverse effects*; D058471:Subretinal Fluid / Q000378:metabolism; D041623:Tomography, Optical Coherence / Q000379:methods; D014792:Visual Acuity
chemical_list: D015415:Biomarkers