Foveal bulge as a predictor of high visual function in rhegmatogenous retinal detachment

Abstract

Introduction. The integrity of photoreceptor's inner segment/outer segment connection plays great importance in predicting visual acuity in eyes with retinal pathology. However, even optical coherence tomographic study showed the intact of retinal layers, including photoreceptor's inner segment/outer segment line, after surgery due to rhegmatogenous retinal detachment (RRD), low visual acuity is observed. Purpose. to identify predictors of high visual acuity in the foveolar zone in patients after successful RRD repair according to SD-OCT. Material and methods. Group 1 consisted of 20 cases – eyes after successful primary RRD repair performed through pars plana vitrectomy using silicone oil tamponade (1300 cSt), followed by removal of silicone oil with a replacement for sterile air. Group 2 – control, followed eyes without ophthalmopathology and visualisation of foveolar bulge according to OCT. All patients underwent a standard ophthalmological examination and OCT on the 30th day after silicone oil removal. OCT examination was performed by Retina Map and Cross Line modes. The lengths of the outer segments of photoreceptors, inner segments of photoreceptors and the outer nuclear layer of the layer were measured in manual mode. Retina Map was used to measure retinal foveolar thickness. Results. During the study, the data of the foveolar thickness of the retina, the outer nuclear layer and the length of the outer segment of photoreceptors in the main group showed a significant decrease in comparison with the control group (p=0.002, p=0.006, p=0.02, respectively). In this case, a strong correlation was obtained only between the length of the outer segments of photoreceptors and visual acuity (r=0.68). Conclusion. The length of the outer segments of the cones in the central retinal area, or foveolar bulge, should considers a predictor of high visual acuity twostage surgical treatment of primary RRD using silicone oil. Key words: retinal detachment, foveolar bulge, ellipsoid zone, vitrectomy, OCT.