High-resolution Fourier-Domain Optical Coherence Tomography and Microperimetric Findings After Macula-off Retinal Detachment Repair

Abstract

Objective: To evaluate the morphologic changes in the macula of subjects with repaired macula-off retinal detachment (RD) using high-resolution Fourier-domain optical coherence tomography (FD OCT) and to perform functional correlation in a subset of patients using microperimetry (MP-1).Design: Prospective observational case series. Participants: Seventeen eyes from 17 subjects who had undergone anatomically successful repair for macula-off, rhegmatogenous RD at least 3 months earlier and without visually significant maculopathy on funduscopy.Methods: FD OCT with axial and transverse resolution of 4.5 m and 10 to 15 m, respectively, was used to obtain rapid serial B-scans of the macula, which were compared with that from Stratus OCT. The FD OCT B-scans were used to create a 3-dimensional volume, from which en face C-scans were created. Among 11 patients, MP-1 was performed to correlate morphologic changes with visual function.Main Outcome Measures: Stratus OCT scans, FD OCT scans, and MP-1 data.Results: Stratus OCT and FD OCT images of the macula were obtained 3 to 30 months (mean 7 months) postoperatively in all eyes. Although Stratus OCT revealed photoreceptor disruption in 2 eyes (12%), FD OCT showed photoreceptor disruption in 13 eyes (76%). This difference was statistically significant (PϽ0.001, 2 ). Both imaging modalities revealed persistent subretinal fluid in 2 eyes (12%) and lamellar hole in 1 eye. Among 7 subjects who had reliable MP-1 data, areas of abnormal function corresponded to areas of photoreceptor layer disruptions or persistent subretinal fluid in 5 subjects (71%); one subject had normal FD OCT and MP-1.Conclusions: Photoreceptor disruption after macula-off RD repair is a common abnormality in the macula that is detected better with FD OCT than Stratus OCT. A good correlation between MP-1 abnormality and presence of photoreceptor disruption or subretinal fluid on FD OCT demonstrates that these anatomic abnormalities contribute to decreased visual function after successful repair. Financial Disclosure(s): The authors have no proprietary or commercial interest in any materials discussed in this article.

Fourier-domain optical coherence tomography of eyes with idiopathic epiretinal membrane: correlation between macular morphology and visual function

“…[16][17][18][19][20][21][22][23] Recent publications using Stratus OCT by Suh et al 5 and Mitamura et al 6 reported a significant association between loss of integrity of the foveal photoreceptor IS-OS junction on OCT findings and visual acuity in eyes with ERM before and after vitrectomy surgery and correlated the integrity of the foveal photoreceptor IS-OS junction as a feature predictive of visual recovery after vitrectomy surgery in eyes with ERM. 5,6 In our study, we found a poor correlation between photoreceptor IS-OS junction disruption seen on Stratus OCT and the photoreceptor IS-OS junction appearance on FD-OCT, showing the limitations of Stratus OCT in detecting abnormalities in the IS-OS junction especially in the presence of macular edema.…”

“…For qualitative comparison of macular thickness maps with MP-1 sensitivity, we overlaid numerical MP-1 data on the fundus image over the retinal thickness map with retinal vessels and foveal center acting as reference points, as carried out previously. 16 …”

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

“…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.…”

Evolution of Outer Retinal Folds Occurring after Vitrectomy for Retinal Detachment Repair

“…4,5 The advent of spectral domain-optical coherence tomography (sd-OCT) has permitted, without invasive intervention, to acquire pathologic data in vivo showing that persistent foveal detachment, distortion, and disruption of outer retinal layers (ORLs) and macular folds are common findings following successful surgery for retinal detachment (RD). [6][7][8][9][10][11][12][13][14] More recently, fundus autofluorescence (FAF), an imaging modality that relies primarily on the fluorescence generated from the bisretinoids of lipofuscin in retinal pigment epithelial cells, also has been used to investigate the morphologic and functional changes occurring after RD repair. Shiragami et al 13 showed that in patients with large, bullous RDs, shifting of the retina from its original position can frequently be observed after vitrectomy and is elegantly depicted by FAF.…”