EVALUATION OF THE MACULAR CHANGES AFTER SUCCESSFUL RETINAL DETACHMENT SURGERY USING OPTICAL COHERENCE TOMOGRAPHY
Journal Title: European Journal of Pharmaceutical and Medical Research - Year 2018, Vol 5, Issue 12
Abstract
Background: Incomplete visual recovery, color vision defects, or persistent metamorphopsia may persist even after successful surgery for rhegmatogenous retinal detachment (RRD), especially in cases of RD with macula off, suggesting microstructural macular damage that standard fundus biomicroscopy could not detect. Methods: We compared swept-source optical coherence tomography imaging with preoperative and postoperative visual acuity to evaluate the relationship between morphological changes in the outer retina and visual outcome and also to detect the changes in the subfoveal choroid thickness after successful repair of RRD with macula off. We enrolled 40 patients (40 eyes) with successful repair of RRD. The mean postoperative follow-up duration at the time of the initial and the final swept-source optical coherence tomography scan was 1.6 and 5.7 months respectively. Results: The mean age of the patients was 59.2± 13.4 years (range: 24-82 years). The mean visual acuity (logarithm of minimal angle of resolution) before surgery was 1.14± 0.64. Disrupted ellipsoid zone was noted in 17 eyes (42.5%). Disrupted external limiting membrane (ELM) was noted in 4 eyes (10%). The mean postoperative visual acuity was 0.85± 0.56. The difference between the visual acuity before and after surgery was statistically significant. Patients with integrity of the ellipsoid zone and ELM were associated with significant visual improvement than patients with disruption of the ellipsoid zone or ELM. There were no statistically significant differences in the mean subfoveal choroidal thickness between the fellow eyes and the operated eyes at the initial and the final swept-source optical coherence tomography scan. Conclusion: the presence of ellipsoid zone or external limiting membrane disruptions seems to correlate with visual acuity outcome after rhegmatogenous retinal detachment repair. The presence of subretinal fluid on the early postoperative swept-source optical coherence tomography images may lead to transient decrease in visual acuity, but subretinal fluid usually seems to resolve spontaneously with long-term follow-up. Retinal detachment surgeries don’t affect the subfoveal choroidal thickness.
Authors and Affiliations
Mansour Hassan Ahmed
Keywords
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