Evolution and significance of choroidal thickness (CT) in rhegmatogenous retinal detachment (RRD)

Session Details

Session Title: Free Paper Session 6: Vitreoretinal Surgery II

Session Date/Time: Thursday 07/09/2017 | 14:30-16:00

Paper Time: 15:24

Venue: Room 111

First Author: : C.Giacuzzo SWITZERLAND

Co Author(s): :    C. Bergin   J. Potic   A. Daruich   J. Pournaras   L. Konstantinidis   T. Wolfensberger              

Abstract Details

Purpose:

To evaluate the changes in choroidal thickness (CT) before and after successful pars-plana vitrectomy (PPV) in rhegmatogenous retinal detachment (RRD) and to compare evolution of CT between macula-ON and macula-OFF RD

Setting:

prospective, observational mono-centric cohort study conducted in the Jules-Gonin Eye Hospital, Lausanne, Switzerland, at the Department for Vitreoretinal Surgery, in the period march 2015 until march 2017

Methods:

54 eyes of 54 patients who underwent PPV using gas tamponade for RRD were included. They were divided into two group according to the extension of the detachment: 24 macula-ON and 26 macula-OFF eyes. All eyes had CT measures at 1 and 3 months postoperatively on optical coherence tomography using enhanced depth images (EDI-OCT). Macula-ON RRDs also had a CT measurement prior to surgery. CT was measured within the proprietary software, from the horizontal line scan from 2.5 mm nasal to 2.5 mm temporal from the fovea. CT was systematically extracted by realigning the ELM segmentation to the choroidal posterior boundary and extracting the “Outer Retinal Layer” (Bruch’s membrane to choroidal posterior boundary). The difference between treated (TE) and fellow eye (FE) was calculated.

Results:

In macula-ON patients mean ages was 59.3 ± 8.5, pre-operatively best corrected visual acuity (BCVA) was 0 logMAR (IQR 0-0.15 ), and at month 3 was 0 logMAR (IQR 0-0.1). In macula-OFF patients mean age was 60.5 ± 9.6, pre-operatively BCVA was 2 logMAR (IQR 1.3-2.3) and at month 3 was 0.2 logMAR (IQR 0.1-0.3). In macula-ON RD the inter-eye difference in CT at the subfoveal location showed a thickening throughout follow up (preoperative 9%±38%, at M1 8%±30% , at M3 4%± 32% ). After macula-OFF RD, a marked thinning was observed in subfoveal intereye difference of CT at M1 (-14%±19%) and M3 (-10%±15%). The inter-eye difference in subfoveal CT between macula-ON and macula-OFF eyes was statistically different at month 1 (p=0.09) and at month 3 (p=0.02)

Conclusions:

Macula-ON showed different recovery paths in comparison with macula-OFF, with respect to choroidal thickness changes. The origin and clinical implications of these changes are not yet known. Further studies are necessary to clarify the relationship between the circulatory alterations, the effect of vitrectomy, cryotherapy/laser therapy and the RD itself to the changes in choroidal thickness.

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