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Samira Khan, Mohamed Gendy, Alice T. Lyon, Manjot Gill; Correlation Between Pre-Operative Spectral Domain Optical Coherence Tomography Features of Macula Involving Rhegmatogenous and Tractional Retinal Detachments and Post-Operative Outcomes. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6358.
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To correlate pre-operative and post-operative spectral-domain optical coherence tomography (SD-OCT) findings with visual recovery in patients with macula involving rhegmatogenous and tractional retinal detachments.
Twenty eyes of twenty patients with macula involving rhegmatogenous retinal detachments and five eyes of five patients with macula involving tractional retinal detachments who underwent successful retinal detachment repair were imaged with SD-OCT pre and post-operatively to correlate changes in retinal morphology and extent of subretinal fluid with visual outcome.
Twenty eyes underwent primary pars plana vitrectomy for rhegmatogenous retinal detachment. Average pre-operative visual acuity is 20/540. Spectral domain optical coherence tomography (SD-OCT) features identified (1) photoreceptor outer segment irregularity, (2) inner segment/ outer segment disruption, (3) external limiting membrane discontinuity and (4) outer nuclear layer changes . Average maximal subretinal fluid height was measured at 1085 microns and presence of subfoveal fluid was recorded in patients with an average of 540 microns. In postoperative period, average visual acuity is 20/260. SD-OCT showed restoration of photoreceptor outer segment irregularity, improved IS/OS disruption, continuous external limiting membrane and improved outer nuclear layers changes. Average maximal subretinal fluid was recorded at 21 microns and average subfoveal thickness was recorded at 275 microns. Five patients with macular involving tractional retinal detachments underwent pars plana vitrectomy with membrane peel. Pre-operative SD-OCT showed abnormal foveal and retinal contour and intraretinal cystic edema associated with epiretinal membrane and vitreo-retinal traction. Average pre-operative retinal thickness ranged from 242 to 1543 microns. Post-operative SD-OCT features include release of vitreo-retinal traction and decreased retinal thickness, range of 185 to 312 microns.
Despite significant disruption of photoreceptors and external limiting membrane layer, abnormal morphology of the outer plexiform layer and extent of subretinal fluid identified on OCT, macula involving rhegmatogenous and tractional retinal detachments following successful re-attachment surgery resulted in anatomic success and improvement of visual acuity.
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