OCT after Retinal Detachment

Abstract

Benson et al1Benson S.E. Schlottmann P.G. Bunce C. et al.Optical coherence tomography analysis of the macula after vitrectomy surgery for retinal detachment.Ophthalmology. 2006; 113: 1179-1183Abstract Full Text Full Text PDF PubMed Scopus (93) Google Scholar found that the presence of subretinal fluid (SRF) at 6 weeks after surgery was associated with a poorer visual outcome at that time point (P = 0.033). I believe this study has some important methodology flaws. My concerns are the following:1The presence of SRF, first described by Wolfensberger and Gonvers2Wolfensberger T.J. Gonvers M. Optical coherence tomography in the evaluation of incomplete visual acuity recovery after macula-off retinal detachments.Graefes Arch Clin Exp Ophthalmol. 2002; 240: 85-89Crossref PubMed Scopus (144) Google Scholar and Hagimura et al,3Hagimura N. Iida T. Suto K. Kishi S. Persistent foveal retinal detachment after successful rhegmatogenous retinal detachment surgery.Am J Ophthalmol. 2002; 133: 516-520Abstract Full Text Full Text PDF PubMed Scopus (120) Google Scholar refers to a hyporeflective image observed only by optical coherence tomography with a normal fundus view. Benson et al state that the SRF could be detected clinically in 8 of 15 patients (53%). Furthermore, SRF was associated with cystoid macular edema in 2 cases.2Kaga et al in 20014Kaga T. Fonseca R.A. Dantas M.A. et al.Optical coherence tomography of bleb-like subretinal lesions after retinal reattachment surgery.Am J Ophthalmol. 2001; 132: 120-121Abstract Full Text Full Text PDF PubMed Scopus (45) Google Scholar described the tomographic characteristics of persistent bleblike subretinal lesions simulating pigment epithelial detachments. Although this finding is completely different from the presence of SRF only observed by optical coherence tomography, the authors include this concept in the study.3In the comparison groups (presence vs. absence of SRF at 6 weeks), patients with macula attached and detached are included.4Finally, other authors5Baba T. Hirose A. Moriyama M. Mochizuki M. Tomographic image and visual recovery of acute macula-off rhegmatogenous retinal detachment.Graefes Arch Clin Exp Ophthalmol. 2004; 242: 576-581Crossref PubMed Scopus (49) Google Scholar have reported that SRF does not influence postoperative visual acuity for at least 6 months. This should be discussed in the article. Author replyOphthalmologyVol. 114Issue 11PreviewWe thank Martínez-Castillo et al for their interest in our article. Their letter, however, suggests that important concepts relevant to it and to the associated literature have not been fully appreciated. Full-Text PDF