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Optical coherence tomography analysis of the macula after vitrectomy surgery for retinal detachment.
Ophthalmology. 2006 Jul; 113(7):1179-83.O

Abstract

OBJECTIVE

To define the incidence, duration, and clinical associations of persistent localized submacular fluid after pars plana vitrectomy (PPV) retinal detachment surgery.

DESIGN

Observational cohort series.

PARTICIPANTS

One hundred patients were identified and recruited into the study.

METHODS

Patients aged 18 years and older who had undergone PPV and gas as a primary procedure for rhegmatogenous retinal detachment and postoperative follow-up were recruited from February through August 2004. All patients underwent clinical examination, optical coherence tomography (OCT) scan of the macula, and retinal thickness analysis scan of the macula. Those patients in whom an abnormality was seen on OCT at 6 weeks after surgery underwent follow-up with repeat of the study investigations at 3, 6, 9, 12, and 18 months after surgery until the abnormality resolved. If no abnormality was seen at the 6-week examination, no further investigation was undertaken. Demographic data, including detachment characteristics, were collected retrospectively from the patient case notes.

MAIN OUTCOME MEASURES

The principle outcome measure was the presence of subretinal fluid (SRF) on OCT at 6 weeks after surgery. Other outcome measures included duration of persistent fluid and association with visual outcome and type and duration of detachment.

RESULTS

One hundred patients were recruited; 15 of these had SRF on OCT performed at 6 weeks after surgery. Subretinal fluid was associated with significantly worse visual acuity (VA) at 6 weeks (P = 0.033, Wilcoxon rank-sum); those with SRF had a median VA of 0.4, and those with no SRF had a median VA of 0.3. The fluid took a median of 5.5 months to resolve. Seven patients had combined PPV and scleral buckle surgery; none of these had fluid at 6 weeks.

CONCLUSIONS

Optical coherence tomography is a useful noninvasive diagnostic method that can detect SRF not appreciated on clinical examination. Persistent SRF after PPV and gas surgery occurred in 15% of patients in this study and was still present in 53% of these at 6 months. The presence of SRF at 6 weeks after surgery was associated with a poorer visual outcome at this time point.

Authors+Show Affiliations

Vitreoretinal Research Unit, Moorfields Eye Hospital, London, United Kingdom.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16647127

Citation

Benson, Sarah E., et al. "Optical Coherence Tomography Analysis of the Macula After Vitrectomy Surgery for Retinal Detachment." Ophthalmology, vol. 113, no. 7, 2006, pp. 1179-83.
Benson SE, Schlottmann PG, Bunce C, et al. Optical coherence tomography analysis of the macula after vitrectomy surgery for retinal detachment. Ophthalmology. 2006;113(7):1179-83.
Benson, S. E., Schlottmann, P. G., Bunce, C., Xing, W., & Charteris, D. G. (2006). Optical coherence tomography analysis of the macula after vitrectomy surgery for retinal detachment. Ophthalmology, 113(7), 1179-83.
Benson SE, et al. Optical Coherence Tomography Analysis of the Macula After Vitrectomy Surgery for Retinal Detachment. Ophthalmology. 2006;113(7):1179-83. PubMed PMID: 16647127.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Optical coherence tomography analysis of the macula after vitrectomy surgery for retinal detachment. AU - Benson,Sarah E, AU - Schlottmann,Patricio G, AU - Bunce,Catey, AU - Xing,Wen, AU - Charteris,David G, Y1 - 2006/04/27/ PY - 2005/08/10/received PY - 2005/11/18/revised PY - 2006/01/19/accepted PY - 2006/5/2/pubmed PY - 2006/7/21/medline PY - 2006/5/2/entrez SP - 1179 EP - 83 JF - Ophthalmology JO - Ophthalmology VL - 113 IS - 7 N2 - OBJECTIVE: To define the incidence, duration, and clinical associations of persistent localized submacular fluid after pars plana vitrectomy (PPV) retinal detachment surgery. DESIGN: Observational cohort series. PARTICIPANTS: One hundred patients were identified and recruited into the study. METHODS: Patients aged 18 years and older who had undergone PPV and gas as a primary procedure for rhegmatogenous retinal detachment and postoperative follow-up were recruited from February through August 2004. All patients underwent clinical examination, optical coherence tomography (OCT) scan of the macula, and retinal thickness analysis scan of the macula. Those patients in whom an abnormality was seen on OCT at 6 weeks after surgery underwent follow-up with repeat of the study investigations at 3, 6, 9, 12, and 18 months after surgery until the abnormality resolved. If no abnormality was seen at the 6-week examination, no further investigation was undertaken. Demographic data, including detachment characteristics, were collected retrospectively from the patient case notes. MAIN OUTCOME MEASURES: The principle outcome measure was the presence of subretinal fluid (SRF) on OCT at 6 weeks after surgery. Other outcome measures included duration of persistent fluid and association with visual outcome and type and duration of detachment. RESULTS: One hundred patients were recruited; 15 of these had SRF on OCT performed at 6 weeks after surgery. Subretinal fluid was associated with significantly worse visual acuity (VA) at 6 weeks (P = 0.033, Wilcoxon rank-sum); those with SRF had a median VA of 0.4, and those with no SRF had a median VA of 0.3. The fluid took a median of 5.5 months to resolve. Seven patients had combined PPV and scleral buckle surgery; none of these had fluid at 6 weeks. CONCLUSIONS: Optical coherence tomography is a useful noninvasive diagnostic method that can detect SRF not appreciated on clinical examination. Persistent SRF after PPV and gas surgery occurred in 15% of patients in this study and was still present in 53% of these at 6 months. The presence of SRF at 6 weeks after surgery was associated with a poorer visual outcome at this time point. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/16647127/Optical_coherence_tomography_analysis_of_the_macula_after_vitrectomy_surgery_for_retinal_detachment_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(06)00118-7 DB - PRIME DP - Unbound Medicine ER -