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Ultrahigh-resolution optical coherence tomography in patients with decreased visual acuity after retinal detachment repair.
Ophthalmology 2006; 113(4):666-72O

Abstract

OBJECTIVE

To assess microstructural changes in the retina that may explain incomplete visual recovery after anatomically successful repair of rhegmatogenous retinal detachments (RD) using ultrahigh-resolution optical coherence tomography (UHR OCT).

DESIGN

Retrospective observational case series.

PARTICIPANTS

Seventeen patients with decreased visual acuity after RD repair. Twelve patients had macula-involving and 5 had macula-sparing RDs.

METHODS

The UHR OCT prototype capable of approximately 3 mum axial resolution was developed for clinical use. The UHR OCT images through the center of the fovea in 17 patients with visual complaints after RD surgery were obtained. Patients were either postoperative patients from the New England Eye Center or tertiary referrals. Baseline visual acuity, preoperative lens status, location of retinal detachment, macular involvement, and postoperative visual acuity were recorded.

MAIN OUTCOME MEASURES

The UHR OCT images after RD repair.

RESULTS

The UHR OCT images were obtained 1 to 84 months (median, 5 months) postoperatively. The mean preoperative logarithm of the minimum angle of resolution (logMAR) visual acuity was 1.37 (Snellen equivalent, 20/390). The mean postoperative logMAR visual acuity was 0.48 (Snellen equivalent, 20/60). Anatomical abnormalities that were detected included distortion of the photoreceptor inner/outer segments (IS/OS) junction in 14 of 17 patients (82%), epiretinal membranes in 10 of 17 patients (59%), residual subretinal fluid in 3 of 17 patients (18%), and cystoid macular edema in 2 of 17 patients (12%). Of the 5 patients with preoperative macula-on detachments, 4 had distortion of the outer retina after RD repair.

CONCLUSIONS

The higher resolution of UHR OCT facilitates imaging of the IS/OS junction. Therefore, UHR OCT is able to confirm prior histopathologic findings that damage to photoreceptor outer segments may occur as a consequence of retinal detachment. This may explain poor postoperative visual acuity in eyes with anatomically successful repair.

Authors+Show Affiliations

New England Eye Center, Tufts-New England Medical Center, Tufts University, Boston, Massachusetts 02111, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

16581427

Citation

Schocket, Lisa S., et al. "Ultrahigh-resolution Optical Coherence Tomography in Patients With Decreased Visual Acuity After Retinal Detachment Repair." Ophthalmology, vol. 113, no. 4, 2006, pp. 666-72.
Schocket LS, Witkin AJ, Fujimoto JG, et al. Ultrahigh-resolution optical coherence tomography in patients with decreased visual acuity after retinal detachment repair. Ophthalmology. 2006;113(4):666-72.
Schocket, L. S., Witkin, A. J., Fujimoto, J. G., Ko, T. H., Schuman, J. S., Rogers, A. H., ... Duker, J. S. (2006). Ultrahigh-resolution optical coherence tomography in patients with decreased visual acuity after retinal detachment repair. Ophthalmology, 113(4), pp. 666-72.
Schocket LS, et al. Ultrahigh-resolution Optical Coherence Tomography in Patients With Decreased Visual Acuity After Retinal Detachment Repair. Ophthalmology. 2006;113(4):666-72. PubMed PMID: 16581427.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ultrahigh-resolution optical coherence tomography in patients with decreased visual acuity after retinal detachment repair. AU - Schocket,Lisa S, AU - Witkin,Andre J, AU - Fujimoto,James G, AU - Ko,Tony H, AU - Schuman,Joel S, AU - Rogers,Adam H, AU - Baumal,Caroline, AU - Reichel,Elias, AU - Duker,Jay S, PY - 2005/06/13/received PY - 2005/12/22/revised PY - 2006/01/03/accepted PY - 2006/4/4/pubmed PY - 2006/4/12/medline PY - 2006/4/4/entrez SP - 666 EP - 72 JF - Ophthalmology JO - Ophthalmology VL - 113 IS - 4 N2 - OBJECTIVE: To assess microstructural changes in the retina that may explain incomplete visual recovery after anatomically successful repair of rhegmatogenous retinal detachments (RD) using ultrahigh-resolution optical coherence tomography (UHR OCT). DESIGN: Retrospective observational case series. PARTICIPANTS: Seventeen patients with decreased visual acuity after RD repair. Twelve patients had macula-involving and 5 had macula-sparing RDs. METHODS: The UHR OCT prototype capable of approximately 3 mum axial resolution was developed for clinical use. The UHR OCT images through the center of the fovea in 17 patients with visual complaints after RD surgery were obtained. Patients were either postoperative patients from the New England Eye Center or tertiary referrals. Baseline visual acuity, preoperative lens status, location of retinal detachment, macular involvement, and postoperative visual acuity were recorded. MAIN OUTCOME MEASURES: The UHR OCT images after RD repair. RESULTS: The UHR OCT images were obtained 1 to 84 months (median, 5 months) postoperatively. The mean preoperative logarithm of the minimum angle of resolution (logMAR) visual acuity was 1.37 (Snellen equivalent, 20/390). The mean postoperative logMAR visual acuity was 0.48 (Snellen equivalent, 20/60). Anatomical abnormalities that were detected included distortion of the photoreceptor inner/outer segments (IS/OS) junction in 14 of 17 patients (82%), epiretinal membranes in 10 of 17 patients (59%), residual subretinal fluid in 3 of 17 patients (18%), and cystoid macular edema in 2 of 17 patients (12%). Of the 5 patients with preoperative macula-on detachments, 4 had distortion of the outer retina after RD repair. CONCLUSIONS: The higher resolution of UHR OCT facilitates imaging of the IS/OS junction. Therefore, UHR OCT is able to confirm prior histopathologic findings that damage to photoreceptor outer segments may occur as a consequence of retinal detachment. This may explain poor postoperative visual acuity in eyes with anatomically successful repair. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/16581427/Ultrahigh_resolution_optical_coherence_tomography_in_patients_with_decreased_visual_acuity_after_retinal_detachment_repair_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(06)00007-8 DB - PRIME DP - Unbound Medicine ER -