Overloaded Dysfunctional RPE Leads to Delayed Absorption of Subretinal Fluid After Retinal Detachment Repair

Persistent subretinal fluid (SRF) can impair visual recovery after vitrectomy or scleral buckling surgery for rhegmatogenous retinal detachment. Several hypotheses have been proposed for delayed absorption of SRF, but the etiology has not been clearly identified. The authors present a patient with persistent SRF after vitrectomy for retinal detachment who developed central serous chorioretinopathy (CSCR) during the postoperative period in the nonoperative eye. Thus, subclinical retinal pigment epithelial (RPE) dysfunction was likely present in the operative eye, and when overloaded with SRF after retinal detachment repair, this manifested as delayed absorption. This may be the first evidence for overloaded, dysfunctional RPE as the etiology for persistent SRF following otherwise uncomplicated retinal detachment repair. The authors propose that RPE dysfunction can manifest as CSCR or, when overloaded with SRF after RD repair, it can also manifest as delayed absorption of SRF. [ Ophthalmic Surg Lasers Imaging Retina . 2017;48:852–855.]