Advantages:

To reveal post-operative specific changes of macular layers using OCT in patients with rhegmatogenous retinal detachment (RD) with macula-off and macula-on pre-op; to provide correlation between OCT changes and post-operative best corrected visual acuity (BCVA).

Methods:

In 42 patients with rhegmatogenous RD in 1 month after pars-plana vitrectomy OCT analysis (HD-OCT, Cirrus, Carl Zeiss, Meditec) was performed to detect changes in retinal layers. Patients were divided into 3 groups: 1st, BCVA lower then 0.1; 2nd, BCVA range 0.1-0.3; and 3rd, BCVA 0.4 and over. Correlation between post-op visual acuity and retinal layers changes using OCT analysis was performed. Comparison of OCT changes in pre-op macula-off and macula-on patients was performed as well.

Effectiveness / Safety:

Owing to study results it is obviously that after pars plana vitrectomy in patients with RD retinal layers undergo incomplete regeneration with accumulation of so-called “mistakes of recovery” that are detected as atrophy or hyperplasia of the damaged tissues. In patients with post-op BCVA 0.4 and over, OCT changes are characterized by photoreceptors differentiation, absence of local defects in and thinning of ganglion cell layer, absence of macular and pseudo holes, absence of detachment and local defects of neuroepithelium in foveal region. In patients with post-op BCVA lower than 0.3, the following changes were detected on OCT scan: thinning of retinal nerve fiber layer, local defects in peripapillary and macular region, presence of epimacular membranes with foveal deformation, decrease of foveal thickness, destruction and atrophy of retinal pigment epithelium.

Take home message:

The frequency of revealed structural changes in macular region using OCT correlates with BCVA in patients with RD in post-operative period and can be used to predict further visual recovery.