Unexpected movement and improvement of residual subretinal fluid after rhegmatogenous retinal detachment surgery.

Purpose: To report an unusual case of subretinal fluid (SRF) movement from the inferior region to the fovea following rhegmatogenous retinal detachment (RRD) surgery in a high myopic patient, despite the closure of the causative retinal tear. Observation: A 38-year-old woman with high myopia and no medical history underwent a scleral buckling procedure for RRD in her right eye. Postoperatively, while the retinal hole was closed, SRF progressively moved from the inferior region towards the fovea. A second surgery (pars plana vitrectomy) was performed due to suspected micro-holes, but none were identified. Despite the absence of micro-holes, SRF continued to shift from the inferior region towards the fovea, eventually leading to foveal detachment over several months. Fluorescein and indocyanine green angiography revealed no abnormalities. Over time, the SRF spontaneously resolved, and the patient retained stable visual acuity of 20/20 with no recurrence. Conclusion and importance: This case highlights an unusual pattern of SRF movement following RRD surgery, initially raising concerns about re-detachment but ultimately resolving spontaneously. The SRF localized within a high-myopia-associated staphyloma, suggesting a possible positional influence. The movement of SRF towards the fovea is generally considered an alarming sign of re-detachment. However, this case suggests that, in some instances, it may represent a natural absorption process rather than disease recurrence. Further studies are needed to understand the mechanisms underlying SRF movement in highly myopic eyes.