Abstract
Purpose :
To describe the histologic findings in the neurosensory retina with swept-source optical coherence tomography (SS-OCT) in patients with macula-off rhegmatogenous retinal detachment (RRD), before and after surgery
Methods :
Prospective study of 36 subjects (36 eyes) with macula-off RRD. SS-OCT (DRI OCT Triton, Topcon) was used for quantitative and qualitative evaluation of the abnormal findings. The images were taken before surgery and at 1 day, 1 week, 1 month, 3, 6, 9 and 12 months after surgery in all patients. Several variables were compared over time with the healthy contralateral eye
Results :
The range of duration of the RDD was from 2 to 258 days. 73%of the eyes had a preoperative best corrected visual acuity (BCVA) ≤ 20/400, and the height of the RRD was 1064 ± 748μm. One month after surgery, 56% of the operated eyes did not present subretinal fluid (SRF) and 78% achieved ≥ 20/200, while at 3 months 100% did not have SRF and 83% achieved ≥ 20/125
During the first 3 months postoperatively, the foveolar and foveal retinal thickness was reduced in all visits (p <0.01), which was recovered after 3 months (p = 0.06)
The foveolar and foveal thickness of the contralateral outer nuclear layer (ONL) decreased significantly in the preoperative of the eyes with RRD (p <0.05) and remain decreased in all postoperative controls up to the third month inclusive (p <0.01), as well as the thickness of inner and outer segments (OS) of the photoreceptors
Conclusions :
The presence of intra-retinal cysts and the increase in the length of the OS of the photoreceptors are the causes of the increase in the total thickness of the detached retina with respect to its contralateral pair. Such thicknesses decrease progressively and in a fast once the retina is reapplied
Regarding the recovery of the ellipsoid zone (EZ) at the foveolar level it is observed that it is slower than
in the rest of the fovea, where it achieves an early increase in thickness and reflectivity. The predominance of cones in the foveola could explain this fact, linked probably with a lower regenerative capacity of the cones with respect to the rods
The histological study in vivo allows to determine the true intraretinal changes that occur after reapplication of the retina. Knowing these changes and studying them prospectively will generate a natural evolution model of the retinal detachment-reapplication process
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.