Correlation Between Spectral-Domain Optical Coherence Tomography Findings and Visual Outcome After Primary Rhegmatogenous Retinal Detachment Repair

Abstract

This study showed that not only the status of the external limiting membrane and the inner/outer segment junction but also the integrity of the intermediate line and the outer nuclear layer thickness changes may be important predictors of postoperative visual outcome after anatomically successful rhegmatogenous retinal detachment repair.

Association of Spectral-Domain Optical Coherence Tomography Findings with Visual Outcome of Macula-Off Rhegmatogenous Retinal Detachment Surgery

“…In addition, we demonstrated that the integrity of backreflection on baseline SD OCT was significantly correlated with postoperative integrities of ELM and the photoreceptor layer in these patients. Previous studies have found that postoperative integrities of the ELM and photoreceptor IS/OS junction were disrupted in RRD patients with poor visual outcomes after successful surgery [23,24,25,26,27]. From these findings, the status of smudged photoreceptor layers described as ‘backreflection' on preoperative SD OCT may be a useful predictive factor for the postoperative visual outcome in macula-off RRD patients, although the precise status of the photoreceptor IS/OS junction and ELM integrities were difficult to analyze.…”

“…Undulation of the separated outer retina was found to be associated with visual outcome [18,19], and the height of the subretinal fluid beneath the fovea on OCT scans has been suggested as a prognostic factor because it can disturb the interaction between the neurosensory retina and the retinal pigment epithelium [19]. In addition, the postoperative status of the photoreceptor inner segment (IS)/outer segment (OS) junction or the ellipsoid zone and external limiting membrane (ELM) have been used to predict the visual outcome in RRD patients [22,23,24,25,26,27]. …”

Association Between Photoreceptor Regeneration and Visual Acuity Following Surgery for Rhegmatogenous Retinal Detachment

“…Spectral-domain optical coherence tomography provided direct visualization of in vivo retinal morphology, allowing high-resolution observation of individual layers of the macula, thereby providing greater information for structural postoperative macular changes. Recent OCT studies have reported disruptions of photoreceptor microstructures and integrity of the outer retinal bands at the fovea in cases of macula-off RRD 5,[17][18][19]32,33 and other retinal diseases (e.g., macular hole 20,34 and central serous chorioretinopathy 35 ). In the present study, SD-OCT facilitated precise measurement of retinal layer thickness and evaluation of outer retinal band integrity.…”

“…Photoreceptor volume in cases of macula-off RRD (i.e., separation of the macula from the retinal pigment epithelium [RPE]) has been shown to be reduced compared to that in cases of macula-on RRD. 5 Persistent functional damage to the macula is observed in a proportion of eyes affected by macula-off RRD. [6][7][8][9][10][11] Factors reportedly associated with functional recovery following macula-off RRD include preoperative VA, 12 duration of macular detachment, 6,8 height of macular detachment, 13,14 and age.…”

“…15 Many studies using SD-OCT have demonstrated that integrity of the ellipsoid zone (EZ; i.e., the junction between the inner and outer segment of photoreceptors) and external limiting membrane (ELM) is significantly correlated with BCVA following retinal reattachment. 5,[16][17][18][19][20][21] However, these reports had considerable limitations, including inconsistencies between duration and location of images taken, a lack of objective assessment of membrane integrity, and decreased band reflectivity due to fragmentation or thinning, which can be observed in 5% of healthy eyes as a result of artifacts.…”