Purpose: To evaluate retinal restoration after subfoveal perfluorcarbon liquid (PFCL) bubble removal by means of autofluorescence, infrared, and spectral domain optical coherence tomography over 2 years of follow-up.
Methods: A 62-year-old patient underwent two 23-gauge vitrectomies in attempt to remove subretinal PFCL retained under the fovea secondary to retinal detachment surgery in the left eye. We assessed best-corrected visual acuity, fundus biomicroscopy, retinal imaging by autofluorescence, infrared, and spectral domain optical coherence tomography at the first observation of retained PFCL, 1 day after the first attempt of PFCL removal, and 1, 30, 90, and 180 days, and 2 years after the second successful removal surgery.
Results: The best-corrected visual acuity improved from 5 to 45 Early Treatment of Diabetic Retinopathy Study letters (1.0 to 0.2 logMAR units) at the end of follow-up. Spectral domain optical coherence tomography scans showed progressive reorganization of the outer limiting membrane and significant restoration of the inner/outer segment photoreceptors junction 2 years after surgery.
Conclusion: Subfoveal PFCL is believed to cause photoreceptor damage in some eyes, probably because of mechanical compression. Innovative methods of imaging such as spectral domain optical coherence tomography and confocal scanning laser ophthalmoscope with infrared and autofluorescence, allow early and clear detection of subfoveal retained PFCL, as well as careful follow-up and easy differential diagnosis. Surgical removal leads to prompt retinal morphologic restoration and functional improvement enduring over time.
Autofluorescence, infrared, and spectral domain optical coherence tomography helped to recognize subfoveal retained perfluorcarbon liquid and to make differential diagnosis toward other macular diseases like cystoid macular edema and/or macular hole. Although perfluorcarbon liquid collection can cause significant damage of the photoreceptors, in the present case, the photoreceptors and inner/outer segment junction restored after 2 years of successful perfluorcarbon liquid removal.
*Department of Ophthalmology, Catholic University “Sacro Cuore-Policlinico A. Gemelli,” Rome, Italy; and
†“G. B. Bietti” Foundation, IRCCS, Rome, Italy.
Reprint requests: Maria C. Savastano, MD, PhD, Department of Ophthalmology, Catholic University “Sacro Cuore-Policlinico A. Gemelli”, Largo A. Gemelli, 1-00168 Rome, Italy; e-mail: firstname.lastname@example.org
None of the authors have any financial/conflicting interests to disclose.