Abstract
Purpose: :
To evaluate the long-term macular morphological changes in subjects after successful macula-off rhegmatogenous retinal detachment (RD) repair using high resolution Fourier-domain optical coherence tomography (FD-OCT).
Methods: :
Six eyes of 6 subjects without maculopathy who had successful macula-off RD repair and imaged with FD-OCT 5 years earlier was reimaged with FD-OCT. Best corrected visual acuity (BCVA) and macular morphologic changes on FD-OCT images from first scan were compared to that of the follow-up scan.
Results: :
Pre-operative BCVA ranged from counting fingers (n=5) to 20/150 (n=1). Mean post-operative follow-up duration was 2.2 mos (range 1 to 3 mos) for the initial scan and 4.9 yrs (range 3.75 to 5.75 yrs) for the follow-up scan. BCVA at time of the initial scan ranged from 20/25 to 20/200. BCVA at time of the follow-up scan ranged from 20/20 to CF (≥ 20/25, n=5). BCVA improved in 4 eyes and worsened in 2 eyes between scans. Among 4 eyes with improved BCVA during follow-up, there was complete or partial resolution of foveal photoreceptor inner segment-outer segment junction (IS-OS) and Verhoeff’s membrane (VM) abnormality seen on initial scan. None of these 4 eyes had subfoveal subretinal fluid (SRF) on initial or final scan. Among two eyes that had worsening of BCVA between scans, one eye had new subfoveal photoreceptor outer segment thinning/defect with persistent foveal IS-OS/ VM abnormality noted on the initial scan. The other eye had persistent patchy photoreceptor loss seen on initial scan with slight subfoveal enlargement of defect.
Conclusions: :
Delayed changes in foveal photoreceptor IS-OS and VM are seen using FD-OCT on long-term follow-up of eyes with successful macula-off rhegmatogenous retinal detachment. Persistent or new disruption of foveal photoreceptor IS-OS and VM is associated with persistent or worsening vision loss while resolution of foveal IS-OS/ VM abnormality is associated with improvement in visual acuity.
Keywords: retinal detachment • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • photoreceptors