Abstract
Purpose::
To evaluate microstructural changes of the macula in patients after anatomically successful repair of macula-involving rhegmatogenous retinal detachment (RD).
Methods::
Macular microstructure of 16 eyes in 16 patients who underwent successful RD repair by primary vitrectomy (12 eyes) or scleral buckling (4 eyes) was assessed by high-definition Fourier-domain optical coherence tomography (FD-OCT). The prototype FD-OCT (Optovue, Fremont, CA) is capable of ~5 µm axial resolution and 3-demensional imaging reconstruction on the basis of FD-OCT serial sections.
Results::
FD-OCT images were obtained 2 weeks to 13 months (mean, 2.4 months) postoperatively. Nine eyes (56%) improved postoperative visual acuity by 2 lines or more in logarithm of the minimum angle of resolution at FD-OCT examination. Anatomical abnormalities at macula were detected in 14 eyes (88%); including disruptions of the junction between the photoreceptor inner and outer segments (IS/OS) in 13 eyes (81%), residual subretinal fluid (SRF) in 5 eyes (31%), epiretinal membranes in 2 eyes (13%), intraretinal microcysts in 2 eyes (13%), and cystoid macular edema (CME) in 1 eye (6%). Of these findings, residual SRF localized at macula was more frequently observed in patients treated with scleral buckling (P=.03). Presence of residual SRF and CME seems to be associated with poorer visual recovery.
Conclusions::
High-definition FD-OCT is a valuable noninvasive tool for evaluating retinal microstructural changes undetectable by conventional clinical examinations. Evaluation of macular status using FD-OCT appears to be important to predict magnitude of visual recovery after successful RD repair.
Keywords: retinal detachment • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • macula/fovea