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Philip Rechl, Julian Klaas, Nikolaus Feucht, Chris Lohmann, Mathias Maier; Morphological parameters and their prognostic value in SD-OCT in patients with center involving retinal detachment. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6569.
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© ARVO (1962-2015); The Authors (2016-present)
Clinical diagnosis of center involving retinal detachment (CIRD) has been widely associated to low visual acuity in spite of successful retinal surgery. The purpose of this study was to define morphological parameters and their prognostic value with regards to a favorable post-surgical outcome.
We retrospectively examined the clinical data of 94 eyes of 94 consecutive patients with rhegmatogenous CIRD (female=32, male=62). All patients underwent successful retinal surgery (complete reattachment after 3 months) and had undergone no prior eye surgery except phaco. We reviewed funduscopy findings, SD-OCT scans as well as BCVA, before and 3 months after surgery. 19 patients were treated with scleral buckle (SB),37 with ppV only, 20 received ppV+SB, 14 phacovitrectomy ,and 4 phacovitrectomy + SB. We correlated a favorable post-surgical outcome such as reading ability (BCVA≤0,4 logMAR) with morphological parameters such as intraretinal cysts (IC), foveal detachment height (FDH), as well as epiretinal and subretinal folds (EF/SF).
In patients with detached foveal and parafoveal regions (n=61) we measured FDH and further subdivided into 5 groups: A (≤250 μm detachment height), B (<250 μm, ≤400μm), C (>400 μm, ≤600 μm), D (>600 μm) and E (not detectable). We found a statistically inverse relationship between functional outcome and FDH, independent of surgical method or lens status. With regards to the extent of intraretinal edema significantly fewer patients reached a favorable visual outcome if there was widespread intraretinal edema. We found the same (statistically significant) relationship concerning the amount of subretinal folds and their prognostic value for post-surgical visual function.
Based on our clinical data we suggest that the restitution of post- operative BCVA might depend amongst others on morphological parameters in SD- OCT, which we defined as foveal detachment height, intraretinal edema as well as epiretinal and subretinal folds. These results could be a basis for further investigation with regards to a morphological classification of center involving retinal detachment and its prognostic value.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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