Maria Chiara Freno*, Maurizio Mete, Grazia Pertile (Negrar, Italy)

Background:

Small bleb-like subretinal lesions (bleb-like syndrome) have been shown to be a relatively common finding after scleral buckling (SB) for retinal detachment (RD), while it is very uncommon after pars plana vitrectomy (PPV). Although bleb-like lesions were previously reported as small pigment epithelium detachment, OCT has demonstrated that they are small focal retinal detachments.

Objective:

To define the incidence, duration and clinical associations of persistent localized sub-macular fluid (SMF) after SB for retinal detachment.

Design:

Observational retrospective study.

Methods:

The clinical records of 230 patients following SB for RD werre reviewed. 13 patients (13 eyes) with bleb-like syndrome were detected. In every case, postoperative subfoveal bleb-like lesions had been recorded. Macula was preoperatively detached in 11 of 13 cases. Every patient underwent a complete ophthalmologic examination and spectral-domain optical coherence tomography (SD-OCT, Spectralis, Heidelberg Engineering, Germany) preoperatively and 1, 3, and 6 months postoperatively.

Results:

Mean preoperative BCVA was 0.32 ± 0.25. Mean postoperative BCVA at 1, 3 and 6 months respectively was 0.44 ± 0.18, 0.55 ± 0.21 and 0.71 ± 0.19. The follow-up period was 1 year. At the end of the follow-up, SMF was not detectable in 6 eyes, with an average disappearance time of 5.9 ± 1.7 months. 5 eyes retained small amounts of SMF, while in 2 eyes the remaining fluid was extrafoveal. SD-OCT demonstrated a progressive decrease in number and size of subretinal fluid pockets. Inner segment-outer segment junction (IS-OS) was barely identifiable where the neuroretina was detached, while it recovered its normal appearance after fluid reabsorption in all but one cases.

Conclusions:

Our data confirm the incidence of bleb-like syndrome after SB procedures and its time course. It could significantly delay functional recovery, though not affecting the final outcome.