Abstract
Purpose :
The clinical differentiation between vision threatening rhegmatogenous retinal detachment (RRD) that needs urgent surgical intervention and mostly non-interventional degenerative retinoschisis (RS) is challenging. The use of optical coherence tomography (OCT) may aid in differentiating between these conditions. However, performing OCT of the peripheral retina can be challenging. The aim of this study is to investigate the usefulness of ultra-widefield fundus autofuorescence (UW-AF) imaging in differentiating between RRD, RS and retinoschisis-related retinal detachment (RSRD).
Methods :
In this study we present the UW-AF imaging findings of 15 non-traumatic RRD preoperative eyes in 15 patients, 19 eyes with RS and 2 eyes with RSRD. From a total of 13 patients, 7 patients had RS bilaterally, 4 patients had RS unilaterally, 1 patient had RSRD unilaterally and 1 patient had RS on right eye and RSRD on the left eye. Imaging was obtained with the Optos 200 Tx (Optos). In all eyes spectral domain OCT (SD-OCT) was performed with the Nidek RS 3000 to confirm the diagnosis of RRD, RS and RSRD.
Results :
All patients (15 eyes of 15 patients) with RRD demonstrate a pattern of hypofluorescence over the area of the retinal detachment with a hyperfluorescent halo at the leading edge of the detachment. In long-standing RRD with demarcation lines posteriorly, UW-AF reveals a patchy hypofluorescent leading edge. The increased height of the subretinal fluid gives a more hypofluorescent signal in comparison with less bullous detachment. The areas of retinal breaks are hyperfluorescent. The bullous RS demonstrate mostly no change or slight change in autofluorescene imaging (either hypo- or hyperfluorescent) with a well-demarcated, thin hypoflurorescent leading egde, particularly where the leading edge is highly elevated. The RSRD demonstrate hyperfluorescent areas where subretinal fluid is present.
Conclusions :
The preliminary findings of this study indicate that UW-AF imaging may aid in differentiating between RRD, RS and RSRD. This is an ongoing study where more patients will be included.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.