Macular Morphological Changes of Persistent Subclinical Subretinal Fluid after Scleral Buckle Surgery:An Optical Coherence Tomography Study

  Objective  To evaluate macular morphological changes by spectral domain optical coherence tomography (3D OCT) in patients with persistent subclinical subretinal fluid after successful scleral buckle surgeries.

  Methods  Totally 19 cases (21 eyes) with incomplete visual acuity recovery or metamorphosis were reviewed. 3D OCT was performed in the macula (size:6 mm×6 mm×1.7 mm; resolution:512×128). The morphological changes of macula including thickness of foveal neuroepithelium, neuroepithelial detachment, inner segment/outer segment (IS/OS) junction were recorded.

  Results  3D OCT showed persistent subclinical subretinal fluid in 15 eyes, and all of them occurred in patients with preoperative macular detachment. Also, 14 of 15 eyes showed disruption of the photoreceptor IS/OS junction, 2 showed irregularity of retinal pigment epithelium reflection signal, and 2 showed thin epiretinal membrane. Seven of these 15 eyes showed discontinuous retinal detachment. During the 3to 12month continuous follow-up for 7 eyes, the neuroepithelial detachment finally disappeared, and the best corrected visual acuity returned to 0.7-1.2.

  Conclusions  3D OCT can demonstrate areas of persistent subclinical subretinal fluid after successful scleral buckle surgeries. Most patients have neural epithelium shallow detachment as well as complete and enhanced IS/OS junction signal.