Abstract
Purpose :
Rhegmatogenous retinal detachment (RRD) is a potential sight-threating disease in which even after surgical repair reduced visual acuity can be found. The development of optical coherence tomograhy (OCT) has allow to understand ultrastructural changes that can be related to poor visual recovery. In this observational retrospective study we used Swept-Source OCT (SW-OCT) technology to correlate ultrastructural changes and correlate them with visual acuity recovery.
Methods :
We reviewed the medical records of patients with primary RRD who underwent surgical repair with 3-port pars plan vitrectomy (PPV). Eyes with coextsting ocular disease related to retinal degeneration, architectural/functional changes or previous surgery were excluded. 18 eyes met criteria. Preoperative evaluation was recorded, inclued measurement of BCVA, preoperative SW-OCT examination. Images were obtained with DRI OCT-1-Atlantis OCT (Topcon Inc, Tokyo, Japan).12-line, 12mm, raster scan centered to the fovea was used. Features (outcomes) evaluated were VMT abnormalities, intraretinal (IRF) or subretinal (SRF) fluid, status of foveal external limiting membrane (ELM), IS/OS junction, intermediate line (IL), outer retinal corrugation (ORC), subfoveal bulge, foveal central thickness (FCT), and outer nuclear layer thickness (ONL). Postoperative BCVA was measure using Snellen Charts, analyzed using logMAR. Postoperative evaluation iincluded SW-OCT using same protocol as mentioned. Statistical analysis used for qualitative values was Mann-Whitney test and Pearson correaltion for quantitive values (using p<0.05 for both). Demographics and preop values - Fisher exact test.
Results :
IS disruption, IS missing and IL disruption showed a tendency to correlated strongly with BVCA (P=0.093, P=0.020, P=0.14, respectively), with a correlation with poorer outcomes (BVCA). The presence of foveal bulge (+) was related to significantyly better BCVA outcomes (P=0.032). ELM disruption, presence of ERM, IRF/SRF, ORC, FCT or ONL showed no relation to postoperative BCVA. Multivariate analysis showed that the presence of foveal bulge was the most important predictor of visual outcome (P , 0.001).
Conclusions :
This study shows that status of IS and IS layers and presence of foveal bulge may be important predictors of visual outcomes after succesful RD repair. Inner retinal changes were not useful as predictors.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.