scholarly journals New optical coherence tomography grading system for macula-off rhegmatogenous retinal detachment: how off is off?

2021 ◽  
Vol 6 (1) ◽  
pp. e000419
Author(s):  
Karl Thomas Boden ◽  
Kai Januschowski ◽  
Peter Szurman ◽  
Anna-Maria Seuthe ◽  
Annekatrin Rickmann ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Retinal Detachment ◽  
Subretinal Fluid ◽  
Optimal Time ◽  
Optimal Timing ◽  
Grading System ◽  
Optical Coherence ◽  
Duration Of Symptoms ◽  
Macular Detachment ◽  
Middle Ring

Background/AimsThe classification of retinal detachment is currently still based on many objective criteria such as duration of symptoms and funduscopic macular status, which leaves some important questions unanswered. The most important factor is the macular status, which is determined using direct or indirect ophthalmoscopy. Optical coherence tomography (OCT) has become a standard tool in clinical practice and enables detecting the exact extent of subretinal fluid in macula-off/on retinal detachment. We introduce a new and simple OCT-based grading system for macular detachment to provide a basis for further investigations to determine the optimal timing for surgery.MethodsWe retrospectively included 155 patients who were treated for retinal detachment. We defined the extent of the macular detachment in six stages based on the Early Treatment Diabetic Retinopathy Study (ETDRS) grid of the OCT scan.The outermost ring of the ETDRS grid was defined as zone 1, the middle ring as zone 2 and the inner ring as zone 3. Only zone 3 differed in the retinal detachment height grades (grade a <250 µm vs grade b >250 µm). Retinal detachment heights that could not be measured were considered grade 4 (ungradable) detachments.ResultsForty-seven patients had no macular involvement (grade 0). Regarding macular detachment, 14 patients had grade 1, 20 had grade 2, 9 had grade 3a, 29 had grade 3b and 36 had grade 4.ConclusionThe newly developed OCT grading system for macular involvement following retinal detachment is a crucial tool to objectively classify a retinal detachment in order to be able to make better statements in the future, like for defining the optimal time for surgical intervention. A secondary benefit of this grading system would be that it improves predicting postoperative visual acuity.

Association of Spectral-Domain Optical Coherence Tomography Findings with Visual Outcome of Macula-Off Rhegmatogenous Retinal Detachment Surgery

2015 ◽  
Vol 234 (2) ◽  
pp. 83-90 ◽  
Author(s):  
Hae Min Kang ◽  
Sung Chul Lee ◽  
Christopher Seungkyu Lee
Keyword(s):  
Optical Coherence Tomography ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Subretinal Fluid ◽  
Visual Outcome ◽  
Spectral Domain ◽  
Optical Coherence ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
Sd Oct

Purpose: To identify prognostic factors for the visual outcome for patients with macula-off rhegmatogenous retinal detachment (RRD). Methods: The medical records of 27 patients (27 eyes) with macula-off RRD were retrospectively investigated. In addition to clinical characteristics, spectral-domain optical coherence tomography (SD OCT) images were analyzed. Results: The central foveal thickness at baseline was 923 ± 499.5 µm, and the mean height of the subretinal fluid was 697.8 ± 463.6 µm. Dropout of backreflection at the fovea was detected on preoperative SD OCT in 8 patients (29.6%). The external limiting membrane was disrupted in 5 patients (18.5%) as was the photoreceptor integrity in 9 patients (33.3%) at 12 months. On multiple regression analysis, backreflection integrity was the only predictive factor for postoperative visual outcome (B = 0.179, p = 0.020). Conclusions: Backreflection integrity on preoperative SD OCT seems to be helpful in predicting the postoperative visual outcome in macula-off RRD patients.

Macular optical coherence tomography findings after vitreoretinal surgery for rhegmatogenous retinal detachment

2020 ◽  
Vol 30 (4) ◽  
pp. 805-816
Author(s):  
Michele Coppola ◽  
Alessandro Marchese ◽  
Maria Vittoria Cicinelli ◽  
Alessandro Rabiolo ◽  
Chiara Giuffrè ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Subretinal Fluid ◽  
Vitreoretinal Surgery ◽  
Optical Coherence ◽  
Cross Sectional ◽  
Epiretinal Membranes ◽  
Funduscopic Examination

The primary aim of this study was to summarize and illustrate the main structural cross-sectional optical coherence tomography findings encountered after vitreoretinal surgery for rhegmatogenous retinal detachment. This was a non-systematic review of literature on structural cross-sectional optical coherence tomography findings after vitreoretinal surgery for rhegmatogenous retinal detachment. Adequate illustrations of the main findings described were found after a retrospective analysis of imaging and charts of patients operated at the department where this study was performed. The main structural cross-sectional optical coherence tomography findings after vitreoretinal surgery for rhegmatogenous retinal detachment included persistent subretinal fluid, subretinal blebs, retinal folds, subretinal perfluorocarbon liquids, macular alterations related to silicone oil, epiretinal membranes, proliferative vitreoretinopathy, cystoid macular edema, macular holes, and recurrent retinal detachment. In conclusion, optical coherence tomography was a useful tool after vitreoretinal surgery for rhegmatogenous retinal detachment. Some optical coherence tomography findings may not be evident on fundus examination, and optical coherence tomography can reveal essential details for the clinical management and the visual prognosis. Other findings, despite being visible on funduscopic examination, may be better assessed with the aid of optical coherence tomography. All these elements contribute to support the importance of tomographic assessment in the follow-up of eyes treated for vitreoretinal conditions.

scholarly journals The bifurcation and bump signs: optical coherence tomography (OCT) findings overlying neurosensory retinal detachment

2021 ◽  
Author(s):  
Steven Bloom ◽  
Inder Singal
Keyword(s):  
Optical Coherence Tomography ◽  
Retinal Detachment ◽  
Current Literature ◽  
Plexiform Layer ◽  
Optical Coherence ◽  
Journal Articles ◽  
Macular Detachment ◽  
Temporal Location ◽  
Neurosensory Retinal Detachment

Abstract Purpose To expand the description of a common OCT finding of outer plexiform layer (OPL) splitting overlying neurosensory retinal detachment from various causes, along with a thickened outer plexiform bump at the transition from attached to detached retina.Methods etrospective review of our practice’s image teaching collection and database of retina journal articles looking for representative examples of OPL splitting overlying macular detachment. Each of our patient’s scans were then analyzed to see if the location or angle of detachment influenced these findings.Results We analyzed 12 eyes (12 patients) with splitting of the OPL within paracentral detached retina (the “bifurcation sign”) from various causes. A localized thickening of the OPL (the “bump sign”) was present in 6 of these eyes. Although explicitly described in only one publication, the bifurcation sign could be found in numerous prior publications within our journal database. The bump sign, also explicitly described in one prior publication, was also seen in most of these published cases. Surprisingly, these findings appeared unrelated to either the angle of detachment or nasal versus temporal location. We then synthesized our findings with the current literature to help elucidate what this can teach us about current OCT nomenclature for the outer plexiform and outer nuclear layers.Conclusion OPL changes are commonly found with retinal detachment. We suggest a modified classification of the OCT OPL and outer nuclear layers which is only applicable when the normal OCT anatomy is altered either by the OCT technician or overlying retinal detachment.

Feasibility and Clinical Utility of Ultra-Widefield–Navigated Swept-Source Optical Coherence Tomography Imaging

2021 ◽  
pp. 247412642199733
Author(s):  
Kyle D. Kovacs ◽  
M. Abdallah Mahrous ◽  
Luis Gonzalez ◽  
Benjamin E. Botsford ◽  
Tamara L. Lenis ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Clinical Utility ◽  
Clinical Decision Making ◽  
Imaging System ◽  
Imaging Modality ◽  
Case Series ◽  
Subretinal Fluid ◽  
Optical Coherence ◽  
Swept Source ◽  
Oct Imaging

Purpose: This work aims to evaluate the clinical utility and feasibility of a novel scanning laser ophthalmoscope-based navigated ultra-widefield swept-source optical coherence tomography (UWF SS-OCT) imaging system. Methods: A retrospective, single-center, consecutive case series evaluated patients between September 2019 and October 2020 with UWF SS-OCT (modified Optos P200TxE, Optos PLC) as part of routine retinal care. The logistics of image acquisition, interpretability of images captured, nature of the peripheral abnormality, and clinical utility in management decisions were recorded. Results: Eighty-two eyes from 72 patients were included. Patients were aged 59.4 ± 17.1 years (range, 8-87 years). During imaging, 4.4 series of images were obtained in 4.1 minutes, with 86.4% of the image series deemed to be diagnostic of the peripheral pathology on blinded image review. The most common pathologic findings were chorioretinal scars (18 eyes). In 31 (38%) eyes, these images were meaningful in supporting clinical decision-making with definitive findings. Diagnoses imaged included retinal detachment combined with retinoschisis, retinal hole with overlying vitreous traction and subretinal fluid, vitreous inflammation overlying a peripheral scar, Coats disease, and peripheral retinal traction in sickle cell retinopathy. Conclusions: Navigated UWF SS-OCT imaging was clinically practical and provided high-quality characterization of peripheral retinal lesions for all eyes. Images directly contributed to management plans, including laser, injection or surgical treatment, for a clinically meaningful set of patients (38%). Future studies are needed to further assess the value of this imaging modality and its role in diagnosing, monitoring, and treating peripheral lesions.

scholarly journals En face image-based classification of diabetic macular edema using swept source optical coherence tomography

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Atsushi Fujiwara ◽  
Yuki Kanzaki ◽  
Shuhei Kimura ◽  
Mio Hosokawa ◽  
Yusuke Shiode ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Outer Nuclear Layer ◽  
Subretinal Fluid ◽  
Plexiform Layer ◽  
Optical Coherence ◽  
Fiber Layer ◽  
Swept Source ◽  
En Face

AbstractThis retrospective study was performed to classify diabetic macular edema (DME) based on the localization and area of the fluid and to investigate the relationship of the classification with visual acuity (VA). The fluid was visualized using en face optical coherence tomography (OCT) images constructed using swept-source OCT. A total of 128 eyes with DME were included. The retina was segmented into: Segment 1, mainly comprising the inner nuclear layer and outer plexiform layer, including Henle’s fiber layer; and Segment 2, mainly comprising the outer nuclear layer. DME was classified as: foveal cystoid space at Segment 1 and no fluid at Segment 2 (n = 24), parafoveal cystoid space at Segment 1 and no fluid at Segment 2 (n = 25), parafoveal cystoid space at Segment 1 and diffuse fluid at Segment 2 (n = 16), diffuse fluid at both segments (n = 37), and diffuse fluid at both segments with subretinal fluid (n = 26). Eyes with diffuse fluid at Segment 2 showed significantly poorer VA, higher ellipsoid zone disruption rates, and greater central subfield thickness than did those without fluid at Segment 2 (P < 0.001 for all). These results indicate the importance of the localization and area of the fluid for VA in DME.

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