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Panagiotis Salvanos, Jesintha Navaratnam, Jin Ma, Ragnheidur Bragaðóttir, Morten C. Moe; Ultra-widefield Autofluorescence Imaging in the Evaluation of Scleral Buckling Surgery for Retinal Detachment. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4607.
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To investigate the use of ultra-widefield autofluorescence (AF) imaging in the evaluation of scleral buckling surgery for retinal detachment.
A total of 42 eyes from 41 patients that presented at the Section of Surgical Retina with rhegmatogenous retinal detachment, during the period June 2011 to November 2011, were included in this prospective observational study. Ultra-widefield images with AF were obtained using Optomap P200Tx (Optos, Dunfermline, UK). Images were obtained from both eyes pre- and postoperatively. All patients were operated with a 2.5 mm encircling band, a 6-9 mm segmental buckle, cryopexia and the choice of drainage and air/SF6 gas tamponade. Informed consent was obtained from all patients.
The mean age was 57 years (57 ± 12 years), and the female/male ratio was 15/27 (N=42). Ratio macula on/off detachments was 17/25, and the mean follow up 2 ± 1.5 months. In most cases, media opacities (hemorrhage, cataract, vitreous opacities, asteroid hyalosis and intraocular gas) did not hinder the photographic depiction of the retina, including AF images. The extend of cryopexia could be monitored using AF postoperatively; in cases where moderate cryopexia was performed, the retinal tear was surrounded by a hyperfluorescent area. In contrast, in situations where more extensive cryopexia was used the area was hypofluorescent, probably due to extensive disruption of the RPE-cell layer. In cases where a mild buckling effect was achieved, little change to the AF was observed, whereas in cases with more extensive tightening of the band, areas of distinct hyperfluorescence and radial hyperfluorescent streaks were observed. In cases with macula-off surgery, we could observe changes in AF centrally months after reattachment.
Ultra-widefield fundus autofluorescence is a useful adjuvant tool in the examination and follow-up of retinal detachment buckling surgery and offers more insight in the pathophysiological mechanisms of retinal repair after retinal detachment.
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