March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Foveal Architectural Changes in Rhegmatogenous Retinal Detachment as Detected by Intraoperative Optical Coherence Tomography
Author Affiliations & Notes
  • Matthew P. Ohr
    Ophthalmology, Cleveland Clinic, Cleveland, Ohio
  • Sunil Srivastava
    Ophthalmology, Cleveland Clinic, Cleveland, Ohio
  • Peter Kaiser
    Ophthalmology, Cleveland Clinic, Cleveland, Ohio
  • Gina Smith
    Ophthalmology, Cleveland Clinic, Cleveland, Ohio
  • Justis P. Ehlers
    Ophthalmology, Cleveland Clinic, Cleveland, Ohio
  • Footnotes
    Commercial Relationships  Matthew P. Ohr, None; Sunil Srivastava, None; Peter Kaiser, None; Gina Smith, None; Justis P. Ehlers, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 5802. doi:
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      Matthew P. Ohr, Sunil Srivastava, Peter Kaiser, Gina Smith, Justis P. Ehlers; Foveal Architectural Changes in Rhegmatogenous Retinal Detachment as Detected by Intraoperative Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5802.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose:
 

To report the foveal anatomic architectural changes detected by intraoperative optical coherence tomography (iOCT) in patients with macula-involving rhegmatogenous retinal detachment (RRD).

 
Methods:
 

A retrospective consecutive case series identified 8 eyes with RRD examined by iOCT, utilizing a microscope-mounted spectral domain OCT device to obtain images at multiple points throughout the procedure.

 
Results:
 

All 8 eyes underwent a combined scleral buckle/vitrectomy procedure. Perfluorooctane (PFO) was utilized to flatten the retina followed by endolaser photocoagulation and tamponade with perfluoropropane (C3F8) gas. Following PFO infusion, significant foveal and macular architectural changes were noted on iOCT. A thin area of submacular hyporeflectivity corresponding to residual subclinical subretinal fluid was noted in 8/8 eyes. Additionally, prominent foveal changes were noted in all 8 eyes. Three configurations were noted based on iOCT findings. Three eyes (Group 1) demonstrated a definitive full-thickness macular hole (FTMH). Three eyes (Group 2) were found to have an indeterminate FTMH with prominent subretinal hyporeflectivity and foveal thinning. Two eyes (Group 3) demonstrated a smaller area of subfoveal hyporeflectivity. (Figure 1) None of these eyes were noted to have a FTMH pre- or postoperatively.

 
Conclusions:
 

The foveal anatomic architectural changes that occur during retinal detachment repair are poorly understood. We report significant foveal architectural changes as detected by iOCT, including possible FTMH formation in 75% of eyes. The significance of these findings has yet to be realized, and further studies are warranted to determine the impact of these structural anomalies on surgical outcomes and visual acuity. The architectural changes noted with iOCT may provide significant new insight regarding the pathophysiology of macular hole formation following RRD repair.  

 
Keywords: retinal detachment • imaging/image analysis: clinical 
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