Foveal structure in macula-off rhegmatogenous retinal detachment after scleral buckling or vitrectomy

Abstract

Purpose:To evaluate foveal microstructural changes and to determine its association with visual outcomes after reattachment of rhegmatogenous retinal detachments (RRDs) by scleral buckling (SB) or pars plana vitrectomy (PPV).Methods:Using spectral domain optical coherence tomography (SD-OCT), foveal microstructure in eyes with macula-off RRD were studied 1, 3, 6, 9, 12 and 15 months after PPV or SB and correlated with visual outcomes.Results:Forty-two eyes were included in the final analysis. Even with improved microstructural changes and normalization of retinal structures on OCT, final visual acuity was not correlated with microstructural changes in eyes undergoing PPV. In the SB group, final visual acuity was significantly correlated with an intact inner segment/outer segment (IS/OS) junction (P = 0.013). There was no significant correlation between final visual acuity and presence of subretinal fluid (SRF) in either group.Conclusion:After SB, eyes with an intact IS/OS junction had better final visual acuity. In the PPV group, there was no significant correlation between microstructural changes and visual acuity. The presence of SRF did not influence final visual acuity in both groups.

Analysis of microstructural changes in the macular area in patients with macula-off and macula-on rhegmatogenous retinal detachment by optical coherence tomography angiography

“…These postoperative effects are seen as a result of hypoxia that occurs after macular Retinal detachment leads to deterioration in the field of vision. Despite good surgical results, visual acuity recovery may be disappointing for the patient, even in a clinically normal retina due to microstructural changes in the macula (4). The retina has a dual blood supply -from the choroid and its own vasculature, originating from the central retinal artery, a branch of arteria ophthalmica.…”

“…Отлепването на ретината води до дефект в зрителното поле. Въпреки добрите хирургични резултати, зрителното възстановяване може да бъде разочароващо за пациентите, дори при клинично нормално изглеждаща ретина, дължащо се на незначителни промени в макулната микроструктура (4). Ретината има двойно кръвоснабдяване -от хороидеята и от собствената си съдова мрежа, произхождаща от артерия централис ретине, клон на артерия офталмика.…”

OCT Angiography Findings in Macula-ON and Macula-OFF Rhegmatogenous Retinal Detachment: A Prospective Study

“…Studies [ 1 , 2 , 3 ] based on OCT reported different morphologies and complication of retinal reattachment correlated to a lower best-corrected visual acuity (BCVA), a cystoid macular edema (CME), persistent subretinal fluid (PSF), the formation of epiretinal macular membranes (ERM), and the disruption of the inner segment/outer segment (IS/OS). In PPV surgery, current studies relate the possible role of retinal shift on visual acuity [ 4 ].…”

Early Structural and Vascular Changes after Within-24 Hours Vitrectomy for Recent Onset Rhegmatogenous Retinal Detachment Treatment: A Pilot Study Comparing Bisected Macula and Not Bisected Macula

“…However, the anatomical success is not always linked to functional visual recovery and involvement of the macula in the retinal detachment pathogenesis is one of the most important prognostic factors for visual prognosis [ 8 ]. In clinical practice the combination of optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) has allowed a more detailed study of some suboptimal functional recovery causes after surgery, including a refractory cystoid macular edema (CME), persistent subretinal fluid (SRF) and epiretinal membrane (ERM) combined with alteration of the inner segment/outer segment (IS/OS) [ 9 , 10 , 11 , 12 , 13 ], and a more accurate analysis of the pathophysiological changes occurring in the macular microcirculation in retinal diseases, such as diabetic retinopathy, age-related macular degeneration, retinal vein occlusions, uveitis and macular telangiectasias [ 14 ]. Several studies have investigated retinal microvasculature and its changes in ocular diseases after vitreoretinal surgery.…”