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

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.