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Jennifer Beth Nadelmann, Mrinali Patel Gupta, Szilard Kiss, Donald J D'Amico, Anton Orlin; Ultra-wide-field autofluorescence imaging of retinal detachment compared to retinoschisis. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4234. doi: https://doi.org/.
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Localized retinal detachment can appear similar to peripheral retinoschisis based on clinical exam alone. Ultra-wide-field autofluorescence (UAF) imaging is an imaging modality that is used to detect functional changes in the retina. The purpose of this project was to utilize UAF imaging (Optos 200 Tx (Optos)) to characterize retinal changes in patients with the confirmed diagnosis of retinal detachment compared to those with diagnosed retinoschisis to help differentiate these two entities in the era of multimodal imaging.
A retrospective chart review was conducted of patients with the diagnosis of primary rhegmatogenous retinal detachment (RRD) or retinoschisis at Weill Cornell Eye Associates from 2013-2017. Patients were excluded if there was inadequate baseline UAF imaging or substantial unrelated retinal pathology such as diabetic retinopathy or retinal vein occlusions.
38 eyes with retinal detachment and 25 eyes with retinoschisis were included in this study with a mean length of follow up of 470 days. Of the eyes with RRD, 24 (63%) were macula-off. Mean logMAR vision on presentation was 0.075 (Snellen 20/24) in the retinoschisis group and 0.724 (Snellen 20/106) in the RRD group. Initial mean intraocular pressures were 13.75 and 14.32 in the RRD and retinoschisis groups, respectively.On initial presentation ultra-wide-field fundus imaging, 33 (87%) eyes with RRD appeared bullous compared to 11 (44%) eyes with retinoschisis (P=0.005). UAF was considered hypo-autofluorescent in 26 (68.4%) RRD and in 4 (16%) retinoschisis eyes, normal in 1 (2.6%) RRD and in 20 (80%) retinoschisis eyes and hyper-autofluorescent in 11 (29%) RRD and in 2 (4%) retinoschisis eyes (P<0.0001). On evaluation of UAF, 32 (84%) patients with RRD had a hyper-autofluorescent leading edge (HLE) compared to 5 (20%) patients with retinoschisis (P <0.0001). UAF was homogenous in 25 (66%) cases of RRD vs in 25 (100%) cases of retinoschisis (P=0.0008).
This is the first study to date to report differences in UAF imaging between retinal detachment and retinoschisis. In the era of multimodal imaging, UAF can assist the clinical exam in differentiating between these two entities and in assessing clinical prognosis.
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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