No abstract

The objective of this study is to describe the clinical utility and morphologic characteristics of peripheral vitreoretinal interface abnormalities with spectral domain optical coherence tomography (SD-OCT). A prospective imaging analysis of 43 patients with peripheral vitreoretinal interface abnormalities seen on binocular indirect examination with scleral indentation was done. SD-OCT was evaluated for image quality and structural findings. Laser retinopexy was performed to surround all retinal breaks containing a full-thickness component via SD-OCT. Acceptable image quality for inclusion was obtained in 39/43 (91%) patients. Mean age was 41 ± 22 years, and mean follow-up was 14 ± 1.6 months. Decision to treat was altered following SD-OCT in 5% of the patients. Two cases of previously diagnosed operculated holes were found on SD-OCT to be partial-thickness operculated breaks or focal operculated schisis. Peripheral SD-OCT is a reliable and useful technique to examine the structural features of vitreoretinal interface abnormalities in vivo. This imaging modality is useful in the clinical management of suspected retinal breaks identified with indirect ophthalmoscopy.

Subretinal PFO appears as a low-reflectance spherical mass, often with a pinpoint focus of hyperreflectance at the apex of the bubble. Optical coherence tomography details beneath subretinal PFO appear relatively hyperreflectant compared to adjacent tissue. Long-term observation revealed preferential absence of the outer retinal layers with no nerve fiber layer erosion, subretinal inflammatory precipitates, or proliferative vitreoretinopathy. Some evidence of retinal pigment epithelial disruption was observed but seemed to remain stable or improve with observation. The authors suggest management involving follow-up with close observation in SR-PFO unless present in the subfoveal region. Choroidal neovascular membrane can occur after SR-PFO removal and may be successfully managed with intravitreal bevacizumab.

No abstract

No abstract