July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Impact of Intraoperative OCT Parameters on Anatomic and Visual Outcomes in Primary Macula-Involving Retinal Detachments from the PIONEER Study
Author Affiliations & Notes
  • Joseph Roy Abraham
    Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, United States
    Ophthalmology, Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Sunil Srivastava
    Ophthalmology, Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Jamie Reese
    Ophthalmology, Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Justis P Ehlers
    Ophthalmology, Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   Joseph Abraham, None; Sunil Srivastava, Allergen (F), Bausch (C), Bausch (F), Carl Zeiss Meditec (C), Lamb (F), Lomb (C); Jamie Reese, None; Justis Ehlers, Alcon (C), Alcon (F), Bioptigen (C), Bioptigen (P), Genentech (F), Leica (C), Leica (P), Novartis (C), Regeneron (F), Santen (C), Thrombogenics (C), Thrombogenics (F), Zeiss (C)
  • Footnotes
    Support  NIH/NEI K23-EY022947- 01A1 (JPE); Ohio Department of Development TECH-13- 059 (JPE)
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 4232. doi:https://doi.org/
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      Joseph Roy Abraham, Sunil Srivastava, Jamie Reese, Justis P Ehlers; Impact of Intraoperative OCT Parameters on Anatomic and Visual Outcomes in Primary Macula-Involving Retinal Detachments from the PIONEER Study. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4232. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Intraoperative OCT has enabled visualization of subtle structural details during retinal detachment repair. The impact of these features on postoperative outcomes, such as persistent subretinal fluid and visual acuity is unknown. The purpose of this study is to evaluate these intraoperative OCT findings and assess their impact on anatomic and functional outcomes.

Methods : The PIONEER intraoperative OCT study is a prospective IRB-approved study. In this report, we evaluate eyes from the PIONEER study with macula-involving retinal detachments. Inclusion criteria included images obtained following perfluorocarbon liquid (PFO) placement, visualization of the foveal center on OCT, and images of sufficient quality for quantitative assessment of submacular fluid volume. Exclusion criteria included recurrent retinal detachment, proliferative vitreoretinopathy, and a lack of postoperative OCT data after gas bubble resolution. We analyzed sub-PFO subretinal fluid volume on intraoperative OCT imaging through a custom OCT assessment platform. Qualitative review of intraoperative OCTs was performed for visualization of outer retinal bands, subretinal fluid, and retinal corrugations. Postoperative OCTs were analyzed using an ellipsoid zone (EZ) mapping platform to evaluate outer retinal metrics. Postoperative OCTs were also qualitatively reviewed for persistent subretinal fluid presence. Associations between various anatomic and functional outcomes were assessed.

Results : Sixteen eyes of 16 patients were analyzed. All 16 eyes (100%) had subretinal fluid on intraoperative OCT. None of these eyes had persistent subretinal fluid on any postoperative OCT scan. Postoperative quantitative EZ integrity significantly directly correlated with visual outcome (p=.01). Increased intraoperative subretinal fluid volume also trended towards significant correlation with visual acuity outcome (p=.07). No other intraoperative OCT features were associated with either visual outcomes or EZ changes from 12 month OCT.

Conclusions : Persistent subretinal fluid under perfluorocarbon liquid tamponade completely resolves and does not appear to be associated with residual postoperative fluid. Postoperative EZ integrity is associated with visual acuity outcome and intraoperative sub-PFO subretinal fluid volume may also be linked to visual outcomes.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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