Intra-retinal and Subretinal Fluid - Steven Cohen - 2025 05 09

In this lecture from the May 2025 USF Imaging Conference, Dr. Steven Cohen provides a comprehensive overview of intra-retinal and subretinal fluid—its causes, pathophysiology, and clinical implications. Using detailed OCT images and case examples, he explains how fluid in the retina is a finding rather than a diagnosis, and how understanding the underlying mechanisms of fluid balance is essential for accurate interpretation and treatment planning.

Dr. Cohen covers the role of the blood-retinal barrier, RPE pump function, and Müller cell physiology in maintaining retinal fluid homeostasis. He presents clinical scenarios involving retinal detachment, optic nerve edema, choroidal disorders, and macular diseases like macular telangiectasia and vitelliform degeneration, emphasizing the diagnostic significance of OCT patterns, fluid location, and chronicity.

The talk also addresses persistent subretinal fluid after RD repair, medication-induced changes (such as MEK inhibitor retinopathy), and when subretinal fluid can occur without active leakage, such as in drusen-associated fluid or choroidal tumors. This lecture is essential viewing for retina specialists, residents, and any clinician seeking to sharpen their interpretation of retinal imaging and improve diagnostic accuracy.