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H. Nakanishi, M. Hangai, Y. Ojima, N. Unoki, A. Tsujikawa, M. Kita, N. Yoshimura; Three-Dimensional Imaging of Macula-Off Retinal Detachment Using Fourier-Domain Optical Coherence Tomography and Its Relationship With Visual Acuity. Invest. Ophthalmol. Vis. Sci. 2007;48(13):137.
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© ARVO (1962-2015); The Authors (2016-present)
It is well-known that the preoperative visual acuity (VA) of macula-off rhegmatogenous retinal detachment (RRD) is a very important predictive factor for visual prognosis after treatment. The purpose of this study is to assess the microstructural changes in the preoperative detached retina by using Fourier domain optical coherence tomography (FD-OCT) and to determine the relationship between the FD-OCT findings and preoperative VA.
FD-OCT was used to examine 14 eyes of 14 patients with macula-off RRD, and 16 eyes of 16 patients with acute central serous chorioretinopathy (CSC) as a control. The interval between onset of symptoms and the FD-OCT examination ranged from 2 to 72 days (mean: 13 days) in the RRD group and from 5 to 53 days (mean: 27 days) in the acute CSC group. The VA ranged from 20/200 to 20/12 (mean: 20/40) and from 20/32 to 20/12.5 (mean: 20/20), respectively. Three-dimensional imaging of the fundus was performed based on a raster scan protocol of 256 × 256 axial scan covering a 2.8 × 2.8 mm macular area. The relationship among the macular characteristics of the OCT images and the preoperative VA of the RRD group was statistically analyzed.
There were some intraretinal morphologic changes in the detached retina of the RRD group: microcysts in the inner nuclear layer (4 eyes, 29%), cystoid/diffuse edema in the outer nuclear layer (9 eyes, 64%), undulated outer retina (6 eyes, 43%), and dropout of foveal photoreceptor inner and outer segments (7 eyes, 50%). None of these findings were detected in the acute CSC group. The height of the detached retina was 583 ± 311 µm in the RRD group and 293 ± 96 µm in the acute CSC group. In RRD group, The height of the detached retina (p=0.0005) and the dropout of foveal photoreceptor inner and outer segments (p=0.03) were statistically correlated with preoperative VA.
FD-OCT can depict intraretinal morphologic changes in the detached macula associated with RRD. The dropout of foveal photoreceptor inner and outer segments may predict poor visual prognosis despite the anatomical success of treatment.
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