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

  • Christina Doefler Poulsen
  • M. P. Petersen
  • A. Green
  • T. Peto
  • J. Grauslund
Retinal Disorders

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 

Notes

Author contributions

CDP, JG, TP, and AG contributed to the concept and design of the study. CDP contributed to the acquisition of data. MPP contributed to the grading of SD-OCT images.

Data analyses were performed by CDP, who also wrote the initial draft of the paper. AG, TP, and JG revised the paper critically for intellectual content. All the authors approved the final version of the paper.

Funding information

This study was funded by grants from Alice Rasmussen Memorial Fund, the Foundation of A. P. Møller and Chastine Mc-Kinney Møller, the Research Grant at the University of Southern Denmark, Director Jakob Madsen and Wife Olga Madsen Foundation, King Christian the X Foundation, Henry and Astrid Møller’s Foundation, A.J. Andersen and Wife Foundation, Einar Willumsen’s Memorial Fund, Department of Clinical Research Foundation at Odense University Hospital, the Region of Southern Denmark, and the Institute of Clinical Research at the University of Southern Denmark.

The included data has not been presented before.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

This study was approved by the Danish Data Protection Agency and the Research Ethics Committee of the Region of Southern Denmark. All parts of the study were conducted in accordance with the Helsinki declaration II and in accordance with good clinical practice.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of OphthalmologyOdense University HospitalOdenseDenmark
  2. 2.Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark
  3. 3.OPEN, Odense Patient data Explorative Network, Odense University Hospital/Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark
  4. 4.Centre for Public HealthQueen’s University BelfastBelfastUK

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