Abstract
Purpose: :
To evaluate foveal microstructural changes in eyes with anatomically successful repair of macula-off rhegmatogenous retinal detachments (RRDs) by Spectral domain OCT.
Methods: :
Retrospective, consecutive, observational case series of twelve eyes of 12 consecutive patients with macula-off RRDs after anatomically successful surgical repair (pars plana vitrectomy or scleral buckling). Each patient underwent the following examinations on the same day: BCVA, ophtalmoscopic fundus examination and Spectral-domain optical coherence tomography (SD-OCT). We divided all patients in 4 groups considering SD-OCT abnormalities. The correlation between the postoperative BCVA and foveal microstructural findings was evaluated.
Results: :
: We obtained SD-OCT images a mean of 9.5 months (range, 2-23) after surgery. All patients presented foveal anatomic abnormalities: absence of the SD-OCT hyper-reflective structure between RPE and IS/OS junction (attributable to the junction between RPE cells and outer segment of the photoreceptors) in 3 eyes (27%, group 1); disruption of the junction between the photoreceptor inner and outer segments (IS/OS) and of external limiting membrane (ELM) in 4 eyes (36%, group 2); subfoveal atrophy in 3 eyes (27%, group 3); residual subretinal fluid in 1 eye (9%, group 4). Group 1 mean postoperative BCVA was 0.63, group 2 was 0.38, group 3 was 0.16, group 4 was 0.5.
Conclusions: :
Foveal microstructural changes after anatomically successful RRD repair could be easily detected by SD-OCT. Disruption of the junction between the photoreceptor IS/OS and of external limiting were previously described. We observed that best postoperative BCVA was related to group 1 in which the hyper-reflective structure between RPE and IS/OS junction couldn't be detected by OCT and with IS/OS junction and ELM integrity. This could be considered as an earlier stage of damage, in which there is a partial atrophy of the outer segment of the photoreceptors that become a SD-OCT hypo-reflective structure
Keywords: retinal detachment • photoreceptors