CORRELATION BETWEEN ELLIPSOID-LINE RESTORATION SPEED AND VISUAL OUTCOME AFTER MACULA-OFF PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT

摘要

Purpose : Controversy exists regarding the microstructural findings that best correlate with functional outcomes in patients with macula-off rhegmatogenous retinal detachment (RRD). We performed a prospective, consecutive, observational case series to study foveal microstructure and correlate these findings with visual function along a 12 month follow-up after performing a successful reattachment surgery. This study tested the hypothesis that the Ellipsoid-line restoration speed may be used as a new predictor of visual acuity in primary macula off RRD. Methods : We included sixty-five eyes of 65 consecutive patients with macula off RRD after successful surgical repair by a pars plana vitrectomy (PPV) alone and gas tamponade. Sixty-five patients diagnosed with macula off primary RRD were imaged using a Spectral Domain optical coherence tomography (SD-OCT) after performing a successful reattachment surgery. Images were acquired in the follow-up visits 1, 3, 6 and 12 months. Main outcome measures were data analysis of images obtained by SD-OCT in the follow-up visits and best corrected visual acuity (BCVA). Ellipsoid-line restoration speed was defined as the celerity of restoration of the Ellipsoid-line signal in the serial SD-OCT images performed at 1,3, 6 and 12 months. Results : Multivariate analysis showed that final BCVA was significantly correlated with the integrity of the photoreceptor Ellipsoid-line and ELM signals (at 1st month: r=0,685; P0,001; at 3rd month: r=0,764, P0,001; at 6th month: r=0,708; P0,001; and 12th month after surgery: r=0,555; P0,001) and foveal thickness (at 1st month: r=0,434, P0,001; 3rd month: r=0,428, P0,001; at 6th month: r=0,614, P0,001; and 12th month after surgery; r=0,580; P0,001). Ellipsoid-line restoration speed significantly correlated with final BCVA (r=0,757; P0,001). Ellipsoid-line restoration speed also correlated to photoreceptor length at final follow-up (r=0,515; P0,001). Conclusions : Integrity of the foveal microstructure and foveal thickness may account for visual restoration in primary macula off RRD repaired by PPV alone. Ellipsoid-line restoration speed may be used as a new predictor of final BCVA in these patients. This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.