Abstract
Purpose :
To study preopererative Spectral Domain-Optical Coherence Tomography (SD-OCT) interest for the diagnosis and the prognosis of macula-on retinal detachment (RD).
Methods :
All patients who presented at the Hôtel-Dieu Hospital, Paris, between November 2013 and November 2014 with a « macula-On » rhegmatogenous RD seen on the non-contact lens fundus examination, were included in this prospective study. On fundus examination, a possible foveal threatening (FT) (i.e. a RD extending within the macular arcade vessels) was noted. Macular status was then confirmed on SD-OCT examination and patients divided in 2 groups, « OCT-Off » or « OCT-On », depending on the presence of a foveal detachment or not. The distance between the fovea and the detachment was measured on SD-OCT for the « OCT-On » RD. Complete clinical examination was performed preoperatively and at 3, 6, 9 and 12 months. The correlation between macular status on SD-OCT and FT status, and between final visual acuity and macular status on SD-OCT were studied.
Results :
Thirty-three eyes of 33 patients were included in this study, with a median follow up of 11 months. A foveal threatening status was present in 22 eyes. Among this patients, 9 eyes (42.8%) had an « OCT-Off » RD. No patients had a foveal detachment among the patients without a FT status. The foveal detachment was statistically associated with the FT status (p=0.005, Fisher’s exact test). Final visual acuity was 0.23 logMAR in the « OCT-Off » group and was statistically worse than in the « OCT-On » group (0.1 logMAR) (p=0.027, Mann Whitney test).
Conclusions :
This study confirms the diagnostic role of preoperative SD-OCT for clinically macula-On RD, to detect a subclinical foveal detachment in almost half of the eyes with a FT status. Moreover, the « OCT-Off » status was significantly associated with lower visual recovery after a long term follow up, suggesting the prognostic purpose of this exam.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.