Macular Hole Following Retained Subfoveal PFCL

Introduction: Perfluorocarbon liquids (PFCLs) were first developed in 1970s as possible substitutes to erythrocytes because of their capacity to dissolve relatively large amounts of oxygen. Based on their properties, PFCL are widely used in complex retinal detachments, but they can cause complications in cases of subretinal retention. Migration of peripherally located subretinal PFCL towards the fovea is well established, but spontaneous resolution of sub-foveal PFCL without surgical evacuation or displacement has rarely been described. Case report: We report a case of a 48 year old male on whom a vitrectomy was performed for a retinal detachment with scleral tear following trauma. PFCL was used for ten days as a temporary intraocular tamponade for retinal flattening. A second vitrectomy was done to replace the PFCL with silicone oil, following which retained sub-foveal PFCL was noted. Result: Fourteen months later, a macular hole developed and PFCL disappeared. Slight superior displacement of the macular area was observed due to contraction of fibrous proliferation superiorly. There was no decrease in visual acuity. Patient was advised to undergo silicon oil removal. CONCLUSION: In the future, improved understanding of the mechanisms of spontaneous resolution may enable the development of non-surgical methods to displace sub-foveal PFCL.