Persistance prolongée de liquide sous-rétinien rétrofovéolaire après un décollement de rétine rhegmatogène

Abstract

Persistent subretinal foveal fluid is responsible for incomplete functional recovery after retinal detachment surgery. The diagnosis may be difficult based on ophtalmoscopy and requires macular optical coherence tomography (OCT). We describe the case of a 25-year-old patient who presented persistence of subretinal foveal fluid over 16 months after an inferior macula off posttraumatic retinal detachment. The patient was initially treated by scleral buckling but the persistence of inferior subretinal fluid led to a second surgery by vitrectomy. The resorption of peripheral subretinal fluid was achieved within one month, but the patient showed incomplete visual function recovery of 3/10 P4 and an OCT macular profile revealed the presence of infraclinical subfoveal fluid. The resorption of this subfoveal fluid was abnormally long with a delay of 16 months before complete reattachment, nonetheless the patient showed an excellent final visual recovery at 8/10 P2. We discuss the reasons for this long resorption of macular subretinal fluid despite a successful surgical treatment. Furthermore the excellent visual recovery suggests a surprisingly good tolerance of chronic macular subfoveal fluid in this pathology. The infraclinical persistence of subfoveal fluid is responsible for delayed functional recovery in patients treated for retinal detachment. Macular OCT allowed an early diagnosis and accurate follow up of these specific patients.