Foveal Microstructure and Visual Acuity after Retinal Detachment Repair. Imaging Analysis by Fourier-Domain Optical Coherence Tomography

Taku Wakabayashi, Yusuke Oshima, Hisataka Fujimoto, Yoko Murakami, Hirokazu Sakaguchi, Sunji Kusaka, Yasuo Tano

Research output: Contribution to journalArticle

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Abstract

Purpose: To evaluate foveal microstructural changes in eyes with anatomically successful repair of rhegmatogenous retinal detachments (RRDs). Design: Retrospective, consecutive, observational case series. Participants: Fifty-three eyes of 51 consecutive patients with macula-on RRDs (15 eyes) or macula-off RRDs (38 eyes) after anatomically successful surgical repair. Methods: A microscopic fundus examination was conducted followed by Fourier-domain optical coherence tomography (FD-OCT) to assess the postoperative foveal microstructure. The correlation between the postoperative best-corrected visual acuity (BCVA) and microstructural findings at the fovea was evaluated. Main Outcome Measures: Images of the foveal microstructure obtained by FD-OCT and the BCVA measured on the same day. Results: We obtained FD-OCT images a mean of 10.3±7.3 months (range, 1-25) postoperatively. Foveal anatomic abnormalities were detected in 33 eyes (62%); disruption of the junction between the photoreceptor inner and outer segments (IS/OS) in 23 eyes (43%), of which 9 eyes (39%) had a disrupted external limiting membrane (ELM); residual subretinal fluid in 6 eyes (11%), epiretinal membranes in 12 eyes (23%), and cystoid macular edema in 2 eyes (4%). Disruption of the photoreceptor IS/OS junction was observed only in macula-off eyes, whereas other microstructural abnormalities were observed in both macula-on and macula-off eyes. In preoperative macula-off eyes, the postoperative BCVA was significantly correlated with the integrity of the photoreceptor IS/OS and ELM signals detected by FD-OCT postoperatively (r = 0.805; P<0.001). Of the 16 eyes followed by FD-OCT, the photoreceptor IS/OS junction was restored in 7 (64%) of the 11 eyes with a disrupted back-reflection line from the IS/OS junction, but without disrupted ELM signals at the initial examination. Of the 5 eyes with disrupted back-reflection lines from both IS/OS junction and ELM at the initial examination, the photoreceptor layer was not restored completely during the follow-up period in any eyes. Conclusions: After anatomically successful RRD repair, FD-OCT is a valuable, noninvasive tool for evaluating foveal microstructural changes. The integrity of the photoreceptor IS/OS junction and ELM signals detected by FD-OCT may account for visual restoration in patients with preoperative macula-off RRDs. Preservation of the ELM postoperatively may predict the subsequent restoration of the photoreceptor layer. Financial Disclosure(s): Proprietary or commercial disclosures may be found after the references.

Original languageEnglish
Pages (from-to)519-528
Number of pages10
JournalOphthalmology
Volume116
Issue number3
DOIs
Publication statusPublished - Mar 1 2009

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Optical Coherence Tomography
Retinal Detachment
Fourier Analysis
Visual Acuity
Membranes
Disclosure
Subretinal Fluid
Epiretinal Membrane
Macular Edema

All Science Journal Classification (ASJC) codes

  • Ophthalmology

Cite this

Foveal Microstructure and Visual Acuity after Retinal Detachment Repair. Imaging Analysis by Fourier-Domain Optical Coherence Tomography. / Wakabayashi, Taku; Oshima, Yusuke; Fujimoto, Hisataka; Murakami, Yoko; Sakaguchi, Hirokazu; Kusaka, Sunji; Tano, Yasuo.

In: Ophthalmology, Vol. 116, No. 3, 01.03.2009, p. 519-528.

Research output: Contribution to journalArticle

Wakabayashi, T, Oshima, Y, Fujimoto, H, Murakami, Y, Sakaguchi, H, Kusaka, S & Tano, Y 2009, 'Foveal Microstructure and Visual Acuity after Retinal Detachment Repair. Imaging Analysis by Fourier-Domain Optical Coherence Tomography', Ophthalmology, vol. 116, no. 3, pp. 519-528. https://doi.org/10.1016/j.ophtha.2008.10.001
Wakabayashi, Taku ; Oshima, Yusuke ; Fujimoto, Hisataka ; Murakami, Yoko ; Sakaguchi, Hirokazu ; Kusaka, Sunji ; Tano, Yasuo. / Foveal Microstructure and Visual Acuity after Retinal Detachment Repair. Imaging Analysis by Fourier-Domain Optical Coherence Tomography. In: Ophthalmology. 2009 ; Vol. 116, No. 3. pp. 519-528.
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title = "Foveal Microstructure and Visual Acuity after Retinal Detachment Repair. Imaging Analysis by Fourier-Domain Optical Coherence Tomography",
abstract = "Purpose: To evaluate foveal microstructural changes in eyes with anatomically successful repair of rhegmatogenous retinal detachments (RRDs). Design: Retrospective, consecutive, observational case series. Participants: Fifty-three eyes of 51 consecutive patients with macula-on RRDs (15 eyes) or macula-off RRDs (38 eyes) after anatomically successful surgical repair. Methods: A microscopic fundus examination was conducted followed by Fourier-domain optical coherence tomography (FD-OCT) to assess the postoperative foveal microstructure. The correlation between the postoperative best-corrected visual acuity (BCVA) and microstructural findings at the fovea was evaluated. Main Outcome Measures: Images of the foveal microstructure obtained by FD-OCT and the BCVA measured on the same day. Results: We obtained FD-OCT images a mean of 10.3±7.3 months (range, 1-25) postoperatively. Foveal anatomic abnormalities were detected in 33 eyes (62{\%}); disruption of the junction between the photoreceptor inner and outer segments (IS/OS) in 23 eyes (43{\%}), of which 9 eyes (39{\%}) had a disrupted external limiting membrane (ELM); residual subretinal fluid in 6 eyes (11{\%}), epiretinal membranes in 12 eyes (23{\%}), and cystoid macular edema in 2 eyes (4{\%}). Disruption of the photoreceptor IS/OS junction was observed only in macula-off eyes, whereas other microstructural abnormalities were observed in both macula-on and macula-off eyes. In preoperative macula-off eyes, the postoperative BCVA was significantly correlated with the integrity of the photoreceptor IS/OS and ELM signals detected by FD-OCT postoperatively (r = 0.805; P<0.001). Of the 16 eyes followed by FD-OCT, the photoreceptor IS/OS junction was restored in 7 (64{\%}) of the 11 eyes with a disrupted back-reflection line from the IS/OS junction, but without disrupted ELM signals at the initial examination. Of the 5 eyes with disrupted back-reflection lines from both IS/OS junction and ELM at the initial examination, the photoreceptor layer was not restored completely during the follow-up period in any eyes. Conclusions: After anatomically successful RRD repair, FD-OCT is a valuable, noninvasive tool for evaluating foveal microstructural changes. The integrity of the photoreceptor IS/OS junction and ELM signals detected by FD-OCT may account for visual restoration in patients with preoperative macula-off RRDs. Preservation of the ELM postoperatively may predict the subsequent restoration of the photoreceptor layer. Financial Disclosure(s): Proprietary or commercial disclosures may be found after the references.",
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T1 - Foveal Microstructure and Visual Acuity after Retinal Detachment Repair. Imaging Analysis by Fourier-Domain Optical Coherence Tomography

AU - Wakabayashi, Taku

AU - Oshima, Yusuke

AU - Fujimoto, Hisataka

AU - Murakami, Yoko

AU - Sakaguchi, Hirokazu

AU - Kusaka, Sunji

AU - Tano, Yasuo

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N2 - Purpose: To evaluate foveal microstructural changes in eyes with anatomically successful repair of rhegmatogenous retinal detachments (RRDs). Design: Retrospective, consecutive, observational case series. Participants: Fifty-three eyes of 51 consecutive patients with macula-on RRDs (15 eyes) or macula-off RRDs (38 eyes) after anatomically successful surgical repair. Methods: A microscopic fundus examination was conducted followed by Fourier-domain optical coherence tomography (FD-OCT) to assess the postoperative foveal microstructure. The correlation between the postoperative best-corrected visual acuity (BCVA) and microstructural findings at the fovea was evaluated. Main Outcome Measures: Images of the foveal microstructure obtained by FD-OCT and the BCVA measured on the same day. Results: We obtained FD-OCT images a mean of 10.3±7.3 months (range, 1-25) postoperatively. Foveal anatomic abnormalities were detected in 33 eyes (62%); disruption of the junction between the photoreceptor inner and outer segments (IS/OS) in 23 eyes (43%), of which 9 eyes (39%) had a disrupted external limiting membrane (ELM); residual subretinal fluid in 6 eyes (11%), epiretinal membranes in 12 eyes (23%), and cystoid macular edema in 2 eyes (4%). Disruption of the photoreceptor IS/OS junction was observed only in macula-off eyes, whereas other microstructural abnormalities were observed in both macula-on and macula-off eyes. In preoperative macula-off eyes, the postoperative BCVA was significantly correlated with the integrity of the photoreceptor IS/OS and ELM signals detected by FD-OCT postoperatively (r = 0.805; P<0.001). Of the 16 eyes followed by FD-OCT, the photoreceptor IS/OS junction was restored in 7 (64%) of the 11 eyes with a disrupted back-reflection line from the IS/OS junction, but without disrupted ELM signals at the initial examination. Of the 5 eyes with disrupted back-reflection lines from both IS/OS junction and ELM at the initial examination, the photoreceptor layer was not restored completely during the follow-up period in any eyes. Conclusions: After anatomically successful RRD repair, FD-OCT is a valuable, noninvasive tool for evaluating foveal microstructural changes. The integrity of the photoreceptor IS/OS junction and ELM signals detected by FD-OCT may account for visual restoration in patients with preoperative macula-off RRDs. Preservation of the ELM postoperatively may predict the subsequent restoration of the photoreceptor layer. Financial Disclosure(s): Proprietary or commercial disclosures may be found after the references.

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