June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Macular Edema After Rhegmatogenous Retinal Detachment Repair: Risk Factors, OCT Analysis, and Treatment Responses.
Author Affiliations & Notes
  • Cameron Pole
    UCLA, Los Angeles, California, United States
  • Ismael Chehaibou
    UCLA, Los Angeles, California, United States
  • Andrea Govetto
    Ophthalmology, Fatebenefratelli Hospital, Milan, Italy
  • Sean Garrity
    Ophthalmology, New England Eye Center/Tufts University, Boston, Massachusetts, United States
  • Steven D Schwartz
    UCLA, Los Angeles, California, United States
  • Jean-Pierre Hubschman
    UCLA, Los Angeles, California, United States
  • Footnotes
    Commercial Relationships   Cameron Pole, None; Ismael Chehaibou, None; Andrea Govetto, None; Sean Garrity, None; Steven Schwartz, None; Jean-Pierre Hubschman, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 3524. doi:
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      Cameron Pole, Ismael Chehaibou, Andrea Govetto, Sean Garrity, Steven D Schwartz, Jean-Pierre Hubschman; Macular Edema After Rhegmatogenous Retinal Detachment Repair: Risk Factors, OCT Analysis, and Treatment Responses.. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3524.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To investigate risk factors, imaging characteristics, and treatment responses of cystoid macular edema (CME) after rhegmatogenous retinal detachment (RRD) repair.

Methods : Consecutive, retrospective case-control series of patients who underwent pars plana vitrectomy (PPV) and/or scleral buckling (SB) for RRD, with at least six months of follow-up. Clinical and surgical parameters of patients with and without CME (nCME), based on spectral-domain optical coherence tomography (OCT), were compared.

Results : Of ninety-nine eyes enrolled, 25 had CME, subgrouped into transient (tCME, <6 months duration) or chronic (cCME, >6 months duration), while 74 had nCME. Macula-off RRD (P = 0.001), proliferative vitreoretinopathy (PVR) (P < 0.0001), and postoperative pseudophakia or aphakia (P < 0.0001) were more frequent in the CME group. Patients with CME underwent greater numbers of surgeries (P < 0.0001). Surgical approaches were significantly different (P < 0.0001), with primary SB in only 1/25 (4%) CME eye vs 25/74 (34%) nCME eyes. Silicone oil was placed in 16/25 (68%) CME eyes vs 4/74 (5%) nCME eyes (P < 0.0001). Characteristics of cCME on OCT included diffuse distribution, confluent cysts, and absence of subretinal fluid or intraretinal hyperreflective foci. Macular thickness improved significantly with intravitreal triamcinolone (P = 0.016) but not with anti-vascular endothelial growth factor agents (P = 0.828) or dexamethasone implant (P = 0.125).

Conclusions : Risk factors of CME include complex retinal detachment repairs and multiple surgeries. Eyes with cCME demonstrated characteristic OCT findings. Although this CME was associated with poor therapeutic response, corticosteroids were the most effective studied treatments.

This is a 2020 ARVO Annual Meeting abstract.

 


Figure 1: Spectral-domain optical coherence tomographies (OCT) and infrared image elevation overlays of two different patients with chronic cystoid macular edema (cCME) post-rhegmatogenous retinal detachment (RRD). In both scans, note diffuse, asymmetric distribution of CME crossing the horizontal raphe, involvement of inner and outer retinal layers, extent to all quadrants, and relative preservation of outer retinal bands subjacent to CME.


Figure 1: Spectral-domain optical coherence tomographies (OCT) and infrared image elevation overlays of two different patients with chronic cystoid macular edema (cCME) post-rhegmatogenous retinal detachment (RRD). In both scans, note diffuse, asymmetric distribution of CME crossing the horizontal raphe, involvement of inner and outer retinal layers, extent to all quadrants, and relative preservation of outer retinal bands subjacent to CME.

 

Figure 2: Spectral-domain optical coherence tomography (OCT) images of chronic cystoid macular edema (CME) post-rhegmatogenous retinal detachment (RRD) repair of the left eye, with dates and visual acuities.

Figure 2: Spectral-domain optical coherence tomography (OCT) images of chronic cystoid macular edema (CME) post-rhegmatogenous retinal detachment (RRD) repair of the left eye, with dates and visual acuities.

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