Multimodal imaging of eyes with metamorphopsia after vitrectomy for rhegmatogenous retinal detachment

Abstract

Purpose: To assess the retinal features in eyes with postoperative metamorphopsia (POM) following rhegmatogenous retinal detachment (RRD) repair using multimodal imaging (MMI). Methods: In this cross-sectional; case-control study, patients after successful RRD repair following 25-gauge vitrectomy, clear vitreous cavity, and corrected distance visual acuity (CDVA)>20/200 were categorized using Amsler chart: cases with POM and controls without POM. MMI was performed on swept-source platform (Triton, Topcon Inc) and the confocal scanning laser ophthalmoscope system (Spectralis HRA, Heidelberg). The measures assessed were CDVA, morphological features on optical coherence tomography, autofluorescence, and multicolor imaging (MCI). Results: Thirty-nine eyes were included in each group. Cases had greater number of eyes with total RRD ( P = 0.029) preoperatively; abnormal foveal contour ( P = 0.036), ellipsoid zone (EZ) disruption ( P < 0.001) and poorer postoperative CDVA ( P = 0.046) as compared to controls. Outer retinal folds and retinal shift (unintentional translocation of retina after reattachment surgery for RRD) did not differ significantly between the groups ( P = 0.48 and 0.35, respectively). On MCI, the distribution of detected ERM was similar between the groups ( P = 0.25). Postoperative CDVA was significantly worse in eyes with POM. Conclusion: POM is affected by extent of RRD, postoperative foveal contour, and EZ status but not by retinal shift.

Optical Coherence Tomography Findings in Rhegmatogenous Retinal Detachment: A Systematic Review

“…Research has been conducted in order to identify factors associated with postoperative metamorphopsia following successful vitrectomy for retinal detachment. Using SS-OCT, Kumar and colleagues found that the preoperative extent of the detachment, postoperative foveal contour, and the continuity of the ellipsoid zone are significantly associated with the occurrence of postoperative metamorphopsia [ 28 ].…”

“…Among the potential biomarkers predicting functional recovery, the grade of detachment and the extent of cystoid macular edema seems promising in eyes with a detached fovea, as well as the integrity of the ellipsoid zone [ 14 , 30 ]. The extent of the detachment, the postoperative foveal contour, the integrity of the ellipsoid zone and of the external limiting membrane, and the presence of outer retinal folds, seem to be predictors of visual prognoses and metamorphopsia following a successful vitrectomy [ 12 , 15 , 16 , 17 , 22 , 28 , 48 , 49 ]. In addition, the thickness of the inner and outer segments of the photoreceptors, and thickness changes in the outer nuclear layer, may be predictors of the final visual outcome [ 19 , 21 ].…”

Multi-color imaging in a unilateral central retinal artery occlusion following dengue fever: A case report and literature review

“…In this table, we summarized the observations of MCI and its advantages found in published papers. The list is not exhaustive; however, it highlights the salient features of different retinal and choroidal disorders [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38].…”