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USING PATIENT POSITIONING TO PROMOTE RESORPTION OF SUBRETINAL FLUID IN RHEGMATOGENOUS RETINAL DETACHMENT BEFORE PNEUMATIC RETINOPEXY

Dorrepaal, Stephen J. MD, FRCS(C); Gale, Jeffrey MD, FRCS(C)

doi: 10.1097/IAE.0b013e31829f73d5
Original Study

Purpose: The purpose of this study was to determine if the volume of subretinal fluid in patients with acute rhegmatogenous retinal detachment may be reduced through patient positioning before pneumatic retinopexy.

Methods: This was a prospective, masked nonrandomized cohort study examining the change in subretinal fluid volume in patients with rhegmatogenous retinal detachment before and after a 1-hour period of specific head positioning, as measured using B-scan ultrasonography. A series of B-scans, each 2 mm apart in the sagittal plane, were acquired for each eye both before and after the positioning period with the patient lying in a supine position.

Results: Ten patients with acute unilateral rhegmatogenous retinal detachment were enrolled. All patients experienced a reduction in subretinal fluid volume, from a mean prepositioning volume of 0.89 ± 0.63 mL to a mean postpositioning volume of 0.45 ± 0.43 mL. The mean relative reduction in subretinal fluid measured as a percentage of prepositioning subretinal fluid volume was 55.4% ± 20%, ranging from 35.3% to 93.5%.

Conclusion: In patients with acute rhegmatogenous retinal detachment that fall within the classic indications for pneumatic retinopexy, significant reduction of subretinal fluid volume may be obtained through a 1-hour period of patient positioning in a retinal break–dependent manner.

In patients with rhegmatogenous retinal detachment with classic indications for pneumatic retinopexy, subretinal fluid volume may be decreased by positioning patients in a dependent manner for a 1-hour period. This may be useful in facilitating prepneumatic transconjunctival cryopexy and in stabilizing patients with macula-threatening retinal detachments while they await therapy.

Department of Ophthalmology, Hotel Dieu Hospital, Queen's University, Kingston, Ontario, Canada.

Reprint requests: Stephen J. Dorrepaal, MD, FRCS(C), Department of Ophthalmology, Hotel Dieu Hospital, 166 Brock Street, Kingston, Ontario, K7L 5G2, Canada; e-mail: 11sjd1@queensu.ca.

None of the authors have any financial/conflicting interests to disclose.

© 2014 by Ophthalmic Communications Society, Inc.