Longitudinal Assessment of Ellipsoid Zone Recovery Using En Face Optical Coherence Tomography After Retinal Detachment Repair Academic Article uri icon

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abstract

  • Purpose

    Suboptimal functional outcomes after rhegmatogenous retinal detachment (RRD) repair may be related to photoreceptor abnormalities, including alterations of the ellipsoid zone (EZ) that may not be apparent on cross-sectional optical coherence tomography (OCT). This study assessed EZ recovery using en face OCT after RRD repair and its association with visual acuity.

    Design

    Post hoc analysis of a randomized controlled trial.

    Methods

    Patients with macula-off RRD were monitored at 3, 6, 12, and 24 months postoperatively and annually thereafter. En face OCT of the EZ slab were analyzed. Hyporeflective areas were colocalized with EZ abnormalities on cross-sectional OCT B-scans and measured by 2 masked graders. Primary outcome was change in area of EZ hyporeflectivity from 3 to 24 months, and its association with Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity recovery was also assessed.

    Results

    In total, 271 images of 61 patients were assessed. Mean area of hyporeflectivity significantly decreased from 3 to 24 months (-2.98 mm2; 95% CI, 1.82-4.13 mm2; P < .0001), with further reductions up to 4 years. Linear regression revealed an association between change in hyporeflective area and change in the ETDRS letter score from 3 to 24 months (β = -0.31, P = .009, R2 = 14.8%) and between duration of macula-off and change in hyporeflective area from 3 to 24 months (β = -0.37, P = .018, R2 = 13.7%).

    Conclusions

    En face OCT provides a novel biomarker for visualizing and quantifying EZ recovery after RRD repair that is associated with ETDRS visual acuity recovery. A steady decline in the area of EZ hyporeflectivity was observed over many years with delayed recovery in patients with longer duration of macula-off.

authors

  • Figueiredo, Natalia
  • Sarraf, David
  • Gunnemann, Frederic
  • Sadda, Srinivas R
  • Bansal, Aditya
  • Berger, Alan R
  • Wong, David
  • Kohly, Radha P
  • Kertes, Peter J
  • Hillier, Roxane J
  • Muni, Rajeev H

publication date

  • April 2022