Abstract
Purpose :
To evaluate the microstructural optical coherence tomography (OCT) and fundus autofluorescence (FAF) imaging predictors of visual acuity, metamorphopsia and aniseikonia after retinal detachment repair.
Methods :
Retrospective analysis of 614 eyes of 614 patients who underwent primary rhegmatogenous retinal detachment (RRD) repair. Best corrected visual acuity, metamorphopsia and aniseikonia were formally tested at 3 months post-operatively. Metamorphopsia and aniseikonia were quantitatively assessed with M-CHARTS and the New Aniseikonia Test. High-resolution spectral-domain OCT and FAF images were captured at 3 months post-operatively. Images were assessed for discontinuity of the outer retinal bands on OCT and retinal displacement detected by retinal vessel printings (RVPs) on FAF by 2 masked graders with disagreements adjudicated by a 3rd senior masked grader. Regression analysis was used to determine the imaging predictors of post-operative visual acuity, metamorphopsia and aniseikonia.
Results :
Regression analysis indicated that significant early post-operative (at 3 months) imaging predictors of visual acuity were discontinuity of the external limiting membrane (ELM) (p=0.01) and presence of RVPs on FAF (p=0.033). Discontinuity of interdigitation zone (IZ) was a significant predictor of metamorphopsia [horizontal, MH (p =0.004); vertical, MV (p=0.056); average of MH+MV (p=0.008)] and presence of RVPs was a significant predictor of aniseikonia (p=0.04).
Conclusions :
Post-operative discontinuity of the external limiting membrane and retinal displacement were significant predictors of post-operative visual acuity following RRD repair. Discontinuity of the IZ and retinal displacement were significant predictors of post-operative metamorphopsia and aniseikonia, respectively. Modifications of surgical techniques aimed to reduce post-operative discontinuity of the outer retinal bands and retinal displacement may improve functional outcomes after retinal detachment repair.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.