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Year : 2013  |  Volume : 3  |  Issue : 3  |  Page : 103-107

Optical coherence tomography study of foveal microstructure after successful retinal detachment surgery

Department of Ophthalmology, National University Hospital, College of Medicine, National University, Taipei, Taiwan

Correspondence Address:
Jen-Shang Huang
Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Number 7, Chung- Shan South Road, Taipei
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Source of Support: None, Conflict of Interest: None

DOI: 10.1016/j.tjo.2013.05.002

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Purpose: To evaluate foveal anatomical abnormalities after the successful repair of rhegmatogenous retinal detachments (RRDs) and to investigate the relationship between foveal microstructural changes and postoperative best-corrected visual acuity (BCVA). Materials and methods: This study was a retrospective consecutive case series comprising all RRD patients with anatomical reattachment performed bya single surgeon fromJanuary 2009 toJune 2010. Complete medical and ophthalmic histories, BCVA, duration of symptoms, number of breaks, extent of the retinal detachment (RD), lens status, and type of surgery were preoperatively recorded. The main outcome measurements for data analysis were postoperative BCVA and optical coherence tomography (OCT) imaging of the foveal microstructure. Results: Clinical data and OCT images were obtained from 83 eyes of 80 patients who underwent successful RRD surgeries. Anatomic foveal abnormalities were identified in 72% of eyes, including disruption of the junction between the inner and outer photoreceptor segments (IS/OS) in 59% of all cases with or without external limiting membrane (ELM) disruptions, residual subretinal fluid (7%), epiretinal membranes (22%), cystoid macular edema (7%), uneven surface (4%), retinal pigment epithelium (RPE) defects (1%), RPE folding (1%), and macular holes (2%). Multiple linear regression analysis showed that the significant factors associated with postoperative BCVA were ELM disruption and macular holes. Foveal photoreceptor layer integrity as determined by OCT imaging after a successful macula-off RD repair was used to classify each eye included in the study into one of three subgroups: intact IS/OSjunction and ELM (11), disrupted IS/OS junction but intact ELM (11), and disruption of the IS/OS junction and ELM (37). Mean postoperative BCVA (0.18 ± 0.13 logMAR units, 0.43 ± 0.26 logMAR units, and 0.69 ± 0.42 logMAR units, respectively) was significantly different among these subgroups (p < 0.001). Conclusion: OCT is a useful, noninvasive tool for evaluating foveal microstructural abnormalities and predicting visual outcomes after a successful RRD repair.

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