Ching J. Chen, MD

Objectives: To identify Persistent Occult Subretinal Fluid (POSF) as a contributing factor to the poor visual outcome following a successful retinal detachment repair and to analyze the optical coherence tomography patterns in POSF.

Methods: Retrospective study on 445 patients treated for RD by one surgeon in 4 years.
Results: Surgical procedures include 113 pneumatic retinopexy (PR), 156 pars plana vitrectomy (PPV), 70 scleral bucle (SB) and 106 combined SB and PPV. POSF was found and confirmed by OCT on 21 of 445 (4.7%) patients. POSF was discovered in 11% of SB, 7% of PR, 3% of SB+PPV, and 1% of PPV patients. There were 19% patients with severe form of POSF, 33% with moderate and 48% with mild form of POSF. POSF is not statistical significantly related to the duration of RD. The odds ratio to develop a POSF is higher in SB and PR patients.
Conclusion: POSF is common after a successful RD repair. It occurs more frequently after PR and SB with sub-optimal or no drainage of sub-retinal fluid, and least frequently after PPV. Fundus manifestation is minimal in mild POSF. Severe POSF can significantly compromise the vision and it takes a protracted course to resolve. OCT is the essential test to confirm the diagnosis. Etiology of POSF is unknown, but retinal pigment epithelial cell dysfunction and weakened retinal adhesion after RD may be the contributing factors.

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