Optical coherence tomography automated layer segmentation of macula after retinal detachment repair

Abstract

PurposeTo investigate the thickness of retinal layers and association with final visual acuity using spectral-domain optical coherence tomography (SD-OCT) in macular area of macula-off rhegmatogenous retinal detachment (RRD) patients after a successful macular re-attachment.MethodsIn retrospective study, a total 24 eyes with macula-off RRD were enrolled. All patients underwent vitrectomy to repair RRD. Outer plexiform layer (OPL), outer nuclear layer (ONL), photoreceptor layer (PR), retinal pigment epithelium (RPE) thicknesses were measured by the Spectralis (Heidelberg Engineering, Heidelberg, Germany) SD-OCT with automated segmentation software. The relationship between the thicknesses of each retinal layer and postoperative logarithm of the minimum angle of resolution scale (LogMAR) visual acuity was analyzed.ResultsOPL and RPE thicknesses were not significantly different between the retinal detachment eyes and fellow eyes (P = 0.839, 0.999, respectively). The ONL and photoreceptor thickness were significantly thinner in the retinal detachment eyes (P <0.001 and 0.001, respectively). In the univariate regression analysis, preoperative best corrected visual acuity (BCVA), ONL thickness and photoreceptor thickness showed association with the postoperative BCVA (P = 0.003, <0.001 and 0.024, respectively). In final multiple linear regression model, ONL thickness was the only variable significantly associated with postoperative BCVA (P = 0.044).ConclusionsSegmented ONL and photoreceptor thickness of retinal detachment eyes were significantly thinner than fellow eyes. Segmental analysis of the retinal layer in macular region may provide valuable information for evaluation RRD. And ONL thickness can be used as a potential biomarker to predict visual outcome after RRD repair.

Macular microstructure and visual acuity after macula-off retinal detachment repair by 23-gauge vitrectomy plus silicone endotamponade

“… 18 Similar findings were obtained by Gharbiya et al, 19 where the mean ONLT in the macula-off RD patients was 105±25.2. The correlation between the ONLT and BCVA was also demonstrated by Han and Lee 20 ( P ≤0.001 by univariate regression analysis and P =0.044 by multiple linear regression) and Dooley et al 18 where ONLT in the affected eye was significantly and inversely correlated with the final LogMAR BCVA (Pearson’s correlation: r =−0.65, P =0.006), and Gharbiya et al, 19 where the ONLT was strongly correlated with postoperative BCVA ( r =0.61, P ≤0.001).…”

<p>Retinal Microvasculature Changes After Repair of Macula-off Retinal Detachment Assessed with Optical Coherence Tomography Angiography</p>

“…[34][35][36] Separation of the photoreceptors (PR) from retinal pigment epithelium (RPE) leads to a cascade of molecular 37 and biochemical changes 38,39 that lead to activation of a multitude of pathways including inflammation, 40-44 gliosis 45,46 and reparative attempts, 47,48 however, there is an ensuing neuronal cell death from apoptosis [49][50][51][52] and necrosis [53][54][55] that contributes to loss of PR cells and decreased visual function. 54,[56][57][58][59] The vascular changes associated with RD have not been investigated in similar detail. Sato et al in 1971 12 and Tolentino et al in 1976 13 reported the findings of Fluorescein Angiography (FA) on RD with lattice degeneration focusing mostly in the peripheral changes and reporting flow slowdown, vascular occlusions, arteriovenous shunts and permeability alterations.…”

Different tamponade effects of intraocular silicone oil and sterilized air after single pars plana vitrectomy for rhegmatogenous retinal detachment

“…Before us, study designs of previous researches on fundus observation after RRD surgery divergent widely. Combined operation with cataract surgery [20,21], either or both scleral buckling and PPV [12,13,[17][18][19][20][21], various intraocular tamponade choice [12,15,17,21], could all have impact on fundus structure and vasculature. Moreover, few study focused on the observation of different tamponade effects of silicone oil with other intravitreal materials on fundus structure and vasculature changes after retinal reattachment.…”

“…Detailed fundus imaging and observation are essential to understand the underlying mechanism of SORVL. The application of OCT in RRD patients allowed the detection of microscopic fundus structural abnormalities after retinal repair [13][14][15]. Negative tamponade effects of SO has been described such as thickness change in specific retinal layers and choroidal thinning [14][15][16].…”

“…Different length of postoperative observation time could lead to controversial results [13,17,18]. For retinal repair, single PPV, PPV combined with buckling or cataract surgery, different surgical operations and various tamponade choices could all have impact on postoperative fundus changes [12,13,[17][18][19][20][21]. Moreover, fundus vasculature change after single PPV for RRD has yet to be studied thoroughly.…”