Persistent subretinal fluid following tractional retinal detachment repair: An exploring use of dexamethasone implant

Introduction: To report a successful application of dexamethasone implants in the treatment of a massive amount of persistent subretinal fluid (SRF) following a tractional retinal detachment (TRD) surgery. Case report: A 44-year-old woman was found to have SRF 1 week after a diabetic TRD surgery. The central macular thickness (CMT) reached up to 1.47 mm and remained high after a month's observation. For better restoration, 2 dexamethasone implants (Ozurdex) were applied at postoperative week 5 and 32 respectively and got good outcomes. The SRF decrease showed a close correlation with Ozurdex treatments: The CMT declined quickly in the next 16 weeks both after 2 times of Ozurdex applications (the linear regression slopes of CMT changes: -12.54 and -22.94, respectively). In contrast, in the interval of 2 injections, the CMT had few changes (the slope: -4.667) even if applying an anti-VEGF agent. Eventually, SRF was completely resolved 48 weeks after the surgery. Discussion: Dexamethasone implant can be an option for effective treatment of persistent SRF after TRD repair, especially in some refractory cases. However, the mechanism remains unclear, and the treatment regimen needs to be explored based on more clinical trials.