The effect of single periocular injection of methylprednisolone and drainage of suprachoroidal fluid in the treatment of rhegmatogenous retinal detachment combined with choroidal detachment

• Published in: Eye (London) 2019-09, Vol.33 (9), p.1387-1392
• Main Authors: Wei, Yong, Zhou, RongLe, Wang, Xiaobo, Chen, Xiuju, Chen, Hao
• Format: Article
• Language: English
• Subjects: 692/699/3161/3175; 692/699/3161/3177; Administration, Oral; Adult; Aged; Choroid Diseases - physiopathology; Choroid Diseases - therapy; Choroidal Effusions; Combined Modality Therapy; Drainage - methods; Eye; Female; Glucocorticoids - therapeutic use; Humans; Injection; Injections, Intraocular; Laboratory Medicine; Male; Medicine; Medicine & Public Health; Methylprednisolone; Methylprednisolone - therapeutic use; Middle Aged; Ophthalmology; Pharmaceutical Sciences/Technology; Prednisolone; Prednisolone - therapeutic use; Prospective Studies; Retina; Retinal Detachment - physiopathology; Retinal Detachment - therapy; Silicones; Steroid hormones; Surgery; Surgical Oncology; Treatment Outcome; Vitrectomy
• ISSN: 0950-222X; 1476-5454
• DOI: 10.1038/s41433-019-0420-4

Purpose In this study we compared the anatomic and functional outcomes of two steroid treatments on rhegmatogenous retinal detachment (RRD) combined with choroidal detachment (CD), namely treatment with oral prednisolone (1 mg/kg daily) for 3–7 days before vitrectomy or a single periocular injection of methylprednisolone (40 mg) 1–3 days before vitrectomy. We also analyzed the outcomes of the eyes with subsided CD and the eyes with persistent CD that underwent drainage of suprachoroidal fluids during the vitrectomy. Methods This was a prospective randomized study. Seventy five eyes with RRD combined with CD were divided into 2 groups based on the two different treatment regimens as above. The eyes in each group were further divided into 2 subgroups (A: CD subsided eyes; B: CD persistent eyes) according to the response of CD to the treatment of steroids. Retinal reattachment rates were measured at 6 months after the removal of silicone oil. Results At 6 months after silicone oil removal, the retinal reattachment rate was similar ( p  = 0.666) in the oral prednisolone group (91.7%, 33/36) and the periocular injection group (94.9%, 37/39). Similar retinal reattachment rates ( p  = 0.364) were also found in the CD subsided eyes (97.1%, 34/35) and the CD persistent eyes (90.0%, 36/40). The retinal reattachment rate was comparable among the subgroups ( p  = 0.395; oral prednisolone A group: 95.2%, 20/21; oral prednisolone B group: 86.7%, 13/15; periocular injection A group: 100%, 14/14; periocular injection B group: 92.0%, 23/25). Conclusions For RRD combined with CD, eyes treated with a single periocular injection of methylprednisolone (40 mg, 1–3 days before pars plana vitrectomy) combined with the drainage of suprachoroidal fluids during the surgery had similar anatomic and functional outcomes compared to the eyes treated with oral prednisolone for 3–7 days before vitrectomy.