Abstract
Purpose: :
To describe the fundus auto-fluorescence (AF) features and outcomes after retinal detachment (RD) repair.
Methods: :
This is a retrospective review of 16 patients with RD and repairs performed at the Massachusetts Eye and Ear Infirmary between 2009 and 2010. Auto-fluorescence images acquired by the Blue Peak Spectralis AF (Heidleberg) were qualitatively analyzed.
Results: :
Of the 16 patients reviewed, 10 had macula-off RD and 6 had macula-on RD. Most patients (88%) were treated with pars-plana vitrectomy. Average time from surgical repair to AF imaging was 161 days. Hypo-fluorescence was the most frequently observed feature; 56% showed hypo-fluorescence, 25% showed mixed hypo- and hyper- AF pattern and 19% had normal AF pattern. Most patients showed abnormalities on AF regardless of the type of RD; 90% of patients with macula-off RD had abnormalities of the AF compared to 67% of patients with macula-on RD (p=0.30). However, statistically significant differences were observed between the auto-fluorescence features and outcomes of patients who had macula-off vs macula-on RD repair in this study population. Comparison within the group of patients with macula-off RD showed that these patients were more likely to show hypo-fluorescence features (P= 0.0089) on AF. Comparison within the group of patients with macula-on RD showed no tendency towards a single AF feature (P=0.57). As expected, patients with macula-off RD had worse vision at baseline when compared to macula-on RD. Overall patients in both groups had improvement in their vision however, patients with macula-on RD were more likely to have vision better the 20/40 (P=0.003).
Conclusions: :
In our study population, the most common auto-fluorescence feature after retinal detachment repair was hypo-fluorescence followed by mixed fluorescence and normal fluorescence. Patients who developed macula-off RD are more likely to have hypo-fluorescence features. Auto-fluorescence changes after RD may reflect changes of the RPE or the overlying photoreceptor pathophysiology and may help explain subnormal vision.
Keywords: imaging/image analysis: clinical • retinal detachment • retinal pigment epithelium