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Jessica Taibl, Samir Sayegh; Use of SD-OCT/SLO as an alternative to ultrasonography to monitor patients with recurrent retinal detachments and silicone oil tamponade. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4915.
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To evaluate SD-OCT/SLO as an alternative to B-mode ultrasonography in cases of inferior recurrent retinal detachment with silicone oil tamponade. If repair is done by pars plana vitrectomy and silicone oil tamponade, ultrasound upon follow-up is more difficult, as significant artifact is present. It is therefore necessary to look for alternate ways of evaluating the integrity of the retina after surgical repair that can provide relevant diagnostic information.
3 patients with rhegmatogenous inferior retinal detachments underwent pars plana vitrectomy with a silicone oil tamponade. After surgery, ultrasonography no longer yielded good diagnostic images and another way of determining retinal integrity needed to be explored. The Spectralis HRA/OCT (Heidelberg Engineering, Germany) generates both a high quality en face image (SLO) and OCT image (SD-OCT). OCT is most commonly used to image and section the fovea and peri-foveal area. However, directing the patient to look nasal, temporal, superior, or inferior allows areas in the periphery to be viewed. Once the en face image of interest is visible, the OCT scan can be directed to view a specific area of interest. One of the three patients suffered corneal decompensation, making it difficult to capture a strong SLO/OCT image. In this case, as well as in the other cases, “live” viewing can be achieved and recorded.
The combined use of SD-OCT/SLO can pinpoint the origin of detachment and characterize the extent and amount of fluid and fluid resorption. The OCT set up as implemented in our clinic can propagate a signal through a decompensated edematous cornea and silicone oil. Images can be captured in a regular fashion through use of the software, or live video can be recorded of the session for those patients who are difficult to image.
Using SD-OCT/SLO to image and monitor retinal integrity after detachment repair and silicone oil tamponade is a good alternative to ultrasound, especially in situations where ultrasound is limited. Additionally, SD-OCT/SLO provides more diagnostic information than ultrasonography alone, has higher resolution and works in difficult-to-image patients, and, being non-contact, is more comfortable for the patient.
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