Abstract
Purpose :
To study the predictive value of subfoveal subretinal fluid (SRF) optical density ratio (ODR) measurements in patients with a recent or chronic macula-involving rhegmatogenous retinal detachment (RRD or CRD).
Methods :
We performed a retrospective cohort study on patients who had preoperative SD-OCT for a shallow, macula-involving RRD or CRD between August, 2017 and August, 2018. Exclusion criteria included recurrent macula-involving retinal detachment, vitreous hemorrhage and non-compliance with postoperative care. We used ImageJ software (imagej.nih.gov/ij) to measure the SRF ODR in spectral domain optical coherence tomography (SD-OCT) images (Spectralis HRA/OCT, Heidelberg Engineering Inc.). Approval was obtained from the Institutional Review Board of the University of Kansas School of Medicine.
Results :
Five RRD and four CRD patients met the inclusion criteria from a group of 120 potential study participants. Mean age was 58.8±9.8 years and 61.3±3.3 years for the RRD and CRD groups, respectively. Multimodal regression analysis showed a positive correlation between preoperative subfoveal ODR and visual acuity 1 month postoperatively for RRD patients (correlation coefficient: 1.3±0.08; p-value: 0.04) but not for CRD patients. Subfoveal vs. extrafoveal macular SRF ODR differed significantly for RRD (p-value: 0.03) but not for CRD (p-value: 0.4) patients. There was also a significant difference in pre-foveal vitreous fluid optical density between RRD (mean 45.1±21) and CRD (mean 17.7±6.60) patients (p-value: 0.04). There was no statistical difference preoperatively between anterior and posterior subfoveal SRF optical density in either the RRD or CRD groups (p-values 0.53 and 0.08, respectively). Intraocular pressure 1-month postoperatively was lower in CRD than RRD patients (CRD mean: 10.2±2.2 mmHg; RRD mean: 16±2.8 mmHg; p-value: 0.01).
Conclusions :
The preoperative optical density ratio of subfoveal SRF is potentially useful for predicting the prognosis of surgery for macula-involving shallow RRDs. That was not true for CRDs in our study, perhaps because enough time had elapsed for differences to diminish between subfoveal and extrafoveal SRF. Larger, longer-term studies are needed to determine the predictive value of subfoveal SRF ODR in surgery for shallow macula-involving RRD or CRD.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.