Fundus autofluorescence and spectral domain optical coherence tomography as predictors for long-term functional outcome in rhegmatogenous retinal detachment

Graefes Arch Clin Exp Ophthalmol. 2019 Apr;257(4):715-723. doi: 10.1007/s00417-018-04222-w. Epub 2019 Jan 7.

Abstract

Purpose: To detect pre- and postoperative retinal changes in fundus autofluorescence (AF) and spectral domain optical coherence tomography (SD-OCT) and to correlate these with functional outcome in patients with primary rhegmatogenous retinal detachment (RRD).

Methods: A prospective, 30-month study of patients operated with 25-gauge vitrectomy for primary RRD. Patients were examined preoperatively and after 6 and 30 months, using ultrawide-field AF images (UWFI) (Optos 200Tx) and SD-OCT (Topcon 3D OCT-2000) imaging.

Results: Of 84 patients (84 eyes) included at baseline, 100.0 and 86.9% were re-examined at month 6 and 30, respectively. Preoperative findings such as macular attachment, detachment > 750 μm from foveola, lack of intraretinal separation, and subfoveal elevation ≤ 500 μm were all associated with better BCVA at months 6 and 30. Postoperative disruption of the photoreceptor layer was associated with poor BCVA at month 6 (p < 0.001) but not at month 30. At baseline, AF-demarcation of RRD was demonstrated by a hyperfluorescent edge in 92.0% and was associated with visual impairment at months 6 (p = 0.003) and 30 (p = 0.003). Visual outcome at month 30 was good (≤ 0.3 logMAR (≥ 20/40 Snellen)), regardless of the preoperative, macular status. However, with significantly better visual outcome in patients with macula attachments versus partly or totally macular detachments (p < 0.001).

Conclusion: Fundus AF and SD-OCT is able to identify retinal reestablishment up to 30 months after primary RRD, with good correlation to BCVA. These findings emphasize the importance of long-term studies for final visual recovery.

Keywords: Fundus autofluorescence; Long-term outcome; Optical coherence tomography; Visual outcome Rhegmatogenous retinal detachment; Vitrectomy.

MeSH terms

  • Female
  • Follow-Up Studies
  • Fundus Oculi
  • Humans
  • Male
  • Middle Aged
  • Optical Imaging*
  • Prospective Studies
  • Retina / physiopathology*
  • Retinal Detachment / diagnosis
  • Retinal Detachment / physiopathology*
  • Retinal Detachment / surgery
  • Tomography, Optical Coherence*
  • Vision, Low / physiopathology*
  • Visual Acuity / physiology*
  • Vitrectomy