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Sana Rasool, Rishika Chaudhary, Karen Blachford, Robert Scott, Ann Logan, Richard J Blanch; The functional effects of photoreceptor loss in patients with retinal detachment. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6602.
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© ARVO (1962-2015); The Authors (2016-present)
Photoreceptor apoptosis during a sustained retinal detachment and disruption of the cone-RPE sheath are associated with permanent visual loss. Local retinal structure has not been previously associated with localized retinal sensitivity after retinal detachment. We therefore aimed to assess the relationship between localized photoreceptor degeneration and corresponding retinal sensitivity in this prospective, observational cohort study.
Patients undergoing vitreoretinal surgery to treat rhegmatogenous retinal detachment (RRD) were reviewed before surgery and at 6 months post operatively. Ophthalmological examinations included measurement of best corrected visual acuity (BCVA), slit lamp examination, dilated fundus ophthalmoscopy, spectral domain optical coherence tomography (SD-OCT), and 24-2 Humphrey visual field (HVF). Postoperative outer nuclear layer (ONL) thickness on SD-OCT of both eyes was measured, and HVF analysed in points corresponding to the measured ONL thickness, in affected and unaffected eyes 6 months postoperatively. The effect of ONL thickness on HVF sensitivity and visual acuity was modelled using generalized estimating equations. Student’s t-test was used to compare means.
Of 21 patients, 13 had a macula off RRD. The mean BCVA at presentation for macula off RRD was LOGMAR 1.74, and for macula on was LOGMAR 0.1. Postoperatively, the BCVA for macula off RRD was LOGMAR 0.76 (p=0.006), and for macula on was LOGMAR 0.42 (p=0.210). The mean on ONL thickness for macula on RD was 97.7μm +/- 3.62 compared to 73.1μm +/- 4.98 in macula off RD. There was no reliable effect of ONL thickness on 6 month visual acuity. Every 1μm of ONL thickness was associated with an increase in HVF sensitivity of 0.052dB (p=0.001).
Increased ONL thickness 6 months post-RRD is associated with increased HVF sensitivity, which is the first demonstration of an association between ONL thickness and localized retinal function after RRD.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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