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S. F. Oster, F. Mojana, W. R. Freeman; Evaluation of Post-Operative Scleral Buckle Patients With Spectral Domain Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2010;51(13):6072.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the spectral domain optical coherence tomography (SD-OCT) appearance of the peripheral retina and overlying vitreous after scleral buckle surgery, and to illustrate that SD-OCT is a useful clinical complement in post-operative scleral buckle patients.
We performed a retrospective case series of 13 eyes from 12 patients who underwent scleral buckle surgery and had subsequent simultaneous scanning laser ophthalmoscope (SLO)/SD-OCT images over the area of buckled retina. The Heidelberg Spectralis (Vista, CA) SLO/SD-OCT was used, and a combination of vertical and horizontal scans provided both perpendicular and tangential images over scleral buckles. Simultaneous co-localization with SLO allowed precise correlation of SD-OCT features with retinal findings documented on color fundus photography.
SLO/SD-OCT images were obtained in 13 eyes after scleral buckle surgery, including 7 encircling buckles, 4 radial sponges, and 2 segmental buckles. The SLO/SD-OCT images provided detailed views of attached retina in 11 eyes and elevated retina with persistent sub-retinal fluid in 2 eyes. The scleral buckle indentation was seen clearly in 9 eyes, and the causative retinal break visualized on SD-OCT in 6 cases. In the 2 cases with persistent sub-retinal fluid, overlying retinal flap tears were not well centered on the radial elements. This was confirmed by SD-OCT, which also captured the extent of sub-retinal fluid, allowed for comparison over time post-operatively, and documented its resolution in one case after C3F8 gas injection. A single patient underwent a combined vitrectomy/scleral buckle, and SD-OCT showed bare retinal pigment epithelium in the retinal tear bed and attached surrounding retina. Finally, the overlying vitreous was seen in 10 patients, and in 6 cases residual vitreous strands adherent to the edge of retinal breaks could be documented on SD-OCT.
Simultaneous SLO/SD-OCT allows detailed examination of the peripheral retina and overlying vitreous after scleral buckle surgery. Along with confirmation that the retina is attached and retinal breaks properly positioned, the SLO/SD-OCT can be used in the post-operative management of scleral buckles to identify residual vitreous traction and monitor areas of sub-retinal fluid.
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