June 2020
Volume 61, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2020
INTRAOPERATIVE ASSESSMENT OF VITREOSCHISIS IN RETINAL DETACHMENT
Author Affiliations & Notes
  • Mariaelena Filippelli
    University of Molise, Campobasso , Italy
  • Roberto Dell'Omo
    University of Molise, Campobasso , Italy
    Ophthalmology, A. Cardarelli Hospital, Campobasso, Molise, Italy
  • Pasquale Napolitano
    University of Molise, Campobasso , Italy
  • Francesco Petti
    Ophthalmology, A. Cardarelli Hospital, Campobasso, Molise, Italy
  • Giulia Santillo
    Ophthalmology, A. Cardarelli Hospital, Campobasso, Molise, Italy
  • Nicola Di Gregorio
    Ophthalmology, A. Cardarelli Hospital, Campobasso, Molise, Italy
  • Ciro Costagliola
    University of Molise, Campobasso , Italy
    Ophthalmology, A. Cardarelli Hospital, Campobasso, Molise, Italy
  • Footnotes
    Commercial Relationships   Mariaelena Filippelli, None; Roberto Dell'Omo, None; Pasquale Napolitano, None; Francesco Petti, None; Giulia Santillo, None; Nicola Di Gregorio, None; Ciro Costagliola, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 4385. doi:
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      Mariaelena Filippelli, Roberto Dell'Omo, Pasquale Napolitano, Francesco Petti, Giulia Santillo, Nicola Di Gregorio, Ciro Costagliola; INTRAOPERATIVE ASSESSMENT OF VITREOSCHISIS IN RETINAL DETACHMENT. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4385.

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

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Abstract

Purpose : to investigate if Posterior Vitreous Detachment (PVD) as assessed using B-scan Ultrasonography (B-scan US) and Optical Coherence Tomography (OCT) preoperatively is confirmed during surgery.

Methods : fifty patients with primary rhegmatogenous retinal detachment not complicated by PVR C were assessed using 10 and 20 MHz B-scan US (Quantel Medical Aviso Ultrasound) and OCT (Heidelberg Engineering, Heidelberg, Germany) to evaluate the presence of vitreous detachment before undergoing vitrectomy. Injection of triamcinolone acetonide in order to better visualize the posterior hyaloid and brushing of the retinal surface using a finesseTM flex loop was carried out in all cases intraoperatively. If still attached, the posterior hyaloid was then removed using the loop, serrated forceps and the vitrectome. All vitrectomies were filmed and re-evaluated comparing intraoperative with B-scan and OCT features.

Results : in 16% of cases the hyaloid appeared attacched to the retina on B-scan US, OCT and during surgical manouvers. Conversely, B-scan US, OCT and surgical observation showed a detached hyaloid in twenty-eight cases out of fifty (56%). In 28% of cases, posterior hyaloid seemed to be detached with B-scan US and OCT, but a vitreoschisis was found intraoperatively (Fig. 1).

Conclusions : when performing vitrectomy to repair primary rhegmatogenous retinal detachment it could be advisable to always stain the vitreous and brush the retinal surface in order to ascertain if a posterior vitreoschis is present. Our findings show that in more than one case out of four US and OCT fail to detect vitreoschisis. Further studies are needed to assess whether this maneuver improves the long-term outcome of vitrectomies.

This is a 2020 ARVO Annual Meeting abstract.

 

A) B-scan Ultrasonography and B) Optical Coherence Tomography showing a detached posterior hyaloid C) intraoperative: hyaloid is still attached to the retina and removed using finesseTM flex loop and serrated forceps.

A) B-scan Ultrasonography and B) Optical Coherence Tomography showing a detached posterior hyaloid C) intraoperative: hyaloid is still attached to the retina and removed using finesseTM flex loop and serrated forceps.

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