Francesco Faraldi, MD (Torino, Italy), Chiara M. Eandi, MD (Torino, Italy), Maria Maddalena Rabbione, MD (Torino, Italy), Manuela Fornara, MD (Torino, Italy), Paola Vaona, (Torino, Italy)


Purpose:To investigate the infrared, autofluorescence, optical coherence tomographic (OCT) and microperimetric (MP) features of persistent macular retinal detachments after successfull scleral buckling surgery.


Methods: prospective, consecutive, interventional trial. Ten patients with a persistent foveal detachment of 41 consecutive cases successfully treated with scleral buckling surgery for retinal detachment were examined. Exclusion criteria were vitreoretinopathy grade B and more, traumatical retinal detachment and preexisting macular disorders. All patients completed at least 6 months follow-up. Patients were examined at 48 hours, 1, 3, 6, 9, 12 and 15 months after surgery with a complete ophthalmic examination as well as infrared, autofluorescence and OCT: MP, fluorescein (FAG) and indocyanine green (ICG) angiography were performed 3 to 6 months after surgery and after retinal reattachment.


Results: In all cases the detachment involved the macular area; the retina appeared ophthalmoscopically attached after 24 hour. The subfoveal detachment, non visible at ophthalmoscopical examination, was evident at OCT 48h after surgery and persisted in all cases at 6 months. In none of the examined patients the detachment solved before 12 months. Visual acuity remained stable or increased in all cases. Infrared examination revealed the presence of multiple detachments accross the posterior pole in 5/10 cases. All patients showed stable fixation at microperimetry (100% of points in central 4 degrees, more than 94% of points in central 2 degrees), mean foveal sensitivity was 12.75 ± 4.02 dB.


MP showed in every case a central relative defect with stable fixation. OCT allowed diagnosis of subfoveal liquid and follow-up of receptor layer abnormalities. Finally, infrared and autofluorescence examination were essential for evaluation, without the use of a dye, of extrafoveal detachments non visible with ophthalmoscopy and FAG while very evident in the late phases of ICG.