High-resolution Fourier-Domain Optical Coherence Tomography and Microperimetric Findings After Macula-off Retinal Detachment Repair
Presented in part as a poster at the Association for Research in Vision and Ophthalmology Annual Meeting, Ft Lauderdale, Florida, May 3, 2006, and at the American Academy of Ophthalmology Annual Meeting, Las Vegas, Nevada, November 12, 2006.
Received 27 November 2007; received in revised form 20 April 2008; accepted 23 May 2008. published online 31 July 2008.
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 μm and 10 to 15 μm, 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 (P<0.001, χ2). 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.
Available online: July 31, 2008.
Department of Ophthalmology and Vision Science, University of California Davis Medical Center, Sacramento, California
Correspondence: Susanna S. Park, MD, PhD, Department of Ophthalmology and Vision Science, University of California Davis Medical Center, 4860 Y Street, Suite 2400, Sacramento, CA 95817
Manuscript no. 2007-1532.
Financial Disclosure(s): The authors have no proprietary or commercial interest in any materials discussed in this article.
Supported in part by the National Eye Institute, Bethesda, Maryland (grant no. 014743 [JSW]), and Research to Prevent Blindness, New York (Jules and Doris Stein Professorship [JSW] and unrestricted departmental grant).
ABSTRACT