Investigation Of Macularmicrostructure Afterretinal Detachment With Spectral Domain Optical Coherence Tomography

Purpose: To evaluate the morphological changes of fovea after rhegmatogenous retinal detachment, and investigate their risk factors and effects on pre- and post-operative visual acuity. Method: This retrospective study reviewed the database of spectral domain optical coherence tomography (OCT) and clinical database of patients with rhegmatogenous retinal detachment visiting Joint Shantou International Eye Center, JSIEC from July 2008 to December 2010. The preoperative spectral domain OCT images were evaluated. The clinical data including demographic information, history, pre- and post- operative visual acuity were compared in the groups with and without macular microstructure changes in spectral domain OCT.Result: Totally 177 eyes of 177 patiens with rhegmatogenous retinal detachment were included. Several macular structural abnormalitie were showed in Spectral-domain OCT, such as macular off (86.4%), macular hole(12.1%), epiretinal membrane(25.4%), intraretinal proliferation(1.7%), subretinal proliferation(10.2%), undulations of the outer retina (74.6 %), photoreceptor loss (53.7 %), photoreceptor detachment (20.1%), cystoid edema in the outer nuclear layer (74.6%), cystoid edema in the inner nuclear layer (22.6%), folds of the inner retinal surface (43.8%). Most of these changes were statistically associated with lower pre- and post-operative visual acuity except intra/subretinal proliferation. Photoreceptor loss was statistical correlated with postoperative but not preoperative visual acuities. The foveal thickness was negatively correlating with the high of detachment(r=-0.487,p<0.001) and preoperative best corrected visual acuity(r=-0.306,p=0.001). The independent factors of postoperative best corrected visual acuity were: photoreceptor loss (B=0.225,p=0.038), undulations of the outer layer (B=0.344, p=0.004) and epiretinal membrane (B=0.356,p=0.013) in multiple regression.Conclusion: Spectral domain-OCT provides a useful tool to investigate the macular microstructure changes after retinal detachment. These morphological changes may contribute to the vision loss in retinal detachment. The independent factors of postoperative best corrected visual acuity were: photoreceptor loss, undulations of the outer layer and epiretinal membrane. Further studies were needed to investigate the pathogenesis and prognosis of these morphological changes, explore manner to prevent and treat these changes, and finally improve the functional outcome of retinal detachment.