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L. K. Chang, H. F. Fine, S. Chang; Spectral Domain Oct Imaging of Retinal Detachment Associated With Optic Nerve Anomalies. Invest. Ophthalmol. Vis. Sci. 2009;50(13):6084.
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To describe spectral domain OCT (SD-OCT) findings in eyes with retinal detachment secondary to optic nerve anomalies.
Four eyes of three consecutive patients with optic nerve coloboma or optic disc pit associated with retinal detachment were included in this study. Each eye underwent complete ophthalmic examination, including SD-OCT (Cirrus, Carl Zeiss Meditec Inc, Dublin CA). 6x6 mm scans were centered on the fovea, optic nerve, or peripapillary retina. Two eyes in the study subsequently underwent 23-gauge pars plana vitrectomy with membrane peeling and 15% C2F6 gas tamponade using the Alcon Accurus system (Alcon Laboratories, Forth Worth TX).
Visual acuity at presentation ranged from 20/30 to 20/80. Three eyes had retinal detachment that was confined to the macula. Visual acuity in these eyes ranged from 20/60 to 20/80. One eye had a previous macular detachment that resolved without treatment five years earlier. In all eyes, SD-OCT imaging showed an enlarged excavation associated with the optic nerve, with tissue extending within the excavation to the optic nerve and intraretinal schisis cavities within the peripapillary retina. In two eyes, taut membranes associated with the retinal detachment and possible retinal breaks in the peripapillary tissue. Two patients experienced worsening vision and elected to undergo surgical intervention. In both of these eyes, no definite retinal breaks were found intraoperatively in areas of suspicion identified by pre-operative SD-OCT. Post-operative SD-OCT in both eyes showed resolution of the traction and retinal detachment. Visual acuity improved from 20/100 to 20/40 and from 20/125 to 20/60.
SD-OCT imaging provides greater resolution and sampling density of the peripapillary region than the previous generation of OCT. Identification of a tractional etiology of the retinal detachment associated with optic disc anomalies may influence treatment recommendations and surgical planning. However, anatomic correlates must be interepreted with caution because the unique anatomy may give rise to imaging artifacts.
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