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Simona Maria Caprani, Simone Donati, Serena Battistini, Elena Gibin, Claudio Azzolini; OCT study of macular structure after vitreoretinal surgery for rhegmatogenous retinal detachment. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3831.
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To evaluate macular morphology after vitreo-surgery for rhegmatogenous retinal detachment and the related-progressive visual function.
This retrospective interventional study included consecutive 26 eyes of 26 patients affected by rhegmatogenous retinal detachment who underwent vitreoretinal surgery. Exclusion criteria considered patients affected by diabetic retinopathy, retinal vascular occlusion and posterior uveitis. Baseline and follow up evaluations at month 1, 3 and 6 included complete ophthalmic, instrumental examination and a complete clinical history. Functional evaluation was performed by ETDRS visual acuity and Amsler test. Morphological evaluation was performed by a deep analysis of retinal layers and vitreoretinal interface as well as retinal thickness with SD OCT (Topcon 3D OCT, USA). A standard vitreoretinal surgery (Stellaris Vitrectomy Platform Bausch&Lomb, USA) was performed completed by C3F8 gas endotamponade, laser photocoagulation and/or criopexy. Statistical analysis was performed on collected data.
Macular morphology examination presented different and evolutive features. Presurgical data showed 21 eyes with macular region involvement, 9 eyes with less than 1 peripheral retinal quadrant involved, 17 with more than 2 quadrant involved. Post surgical parameters SD-OCT examination showed a mean retinal thickness of 287,4 µm at month 3, 293.2 µm at month 6. Intraretinal cyts and/or subretinal fluid was diagnosed in 15 eyes at month 1, in 10 eyes at month 3 and 4 patients at month 6; the presence of epiretinal membrane in one eye at month 1, in 5 eyes at month 3, in 7 eyes at month 6. MeanVA was 0,69±0,52 logMAR at baseline, 0.6±0.9 logMAR at month 1, 0.35±0.52 logMAR at month 3, 0.36± 0.71 logMAR at month 6. Persistence of visual methamorphopsia were reported by 12 patients at month 3 and by 6 patients at month 6.
The presence or the persistence of macular edema and intraretinal alteration could influence seriously the visual recovery during follow up. Visual acuity as well as metamorphopsia and relative scotoma represents the main features of these disorders. Nowadays SD-OCT allows to early identify and analyze epiretinal and intraretinal layers integrity for a prompt therapy. We underline that not only preoperative foveal status but also surgical manoeuvres and devices have an important responsibility.
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