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Wide-field autofluorescense imaging to differentiate between retinoschisis and retinal detachment

Session Details

Session Title: FP-16 Vitreoretinal Surgery IV

Session Date/Time: Sunday 14/09/2014 | 11:00-13:00

Paper Time: 12:28

Venue: Boulevard D

First Author: : E.Ng IRELAND

Co Author(s): :    R. Balasubramanian   S. Beatty   S. Welch   P. Hadden   P. Polkinghorne  

Abstract Details

Purpose:

To characterize the wide-field autofluorescence pattern in eyes with retinoschisis and retinal detachments.

Setting:

Tertiary referral centre in Auckland, New Zealand and Waterford, Ireland.

Methods:

Wide-field autofluorescence images (200Tx, Optos, UK) from 12 consecutive eyes of 7 patients with retinoschisis confirmed on optical coherence tomography, has characteristic snowflakes or both were obtained. These were compared to wide-field autofluorescence images of 15 eyes with retinal detachments. A variety of retinal detachments were imaged. These included chronic and acute rhegmatogenous retinal detachments, tractional retinal detachments, serous retinal detachments and retinal breaks with a cuff of subretinal fluid.

Results:

The autofluorescent signals from all eyes with retinoschisis were either iso or slightly hypo-reflective (equally bright or slightly dark) when compared to surrounding normal retina. In contrast, all recent retinal detachments demonstrated hyper-reflective signals (brighter) when compared to surrounding attached retina. A thick hyper-reflective band at the junction between attached and detached retina was seen in chronic retinal detachments. However, peripheral to this hyper-reflective band, the autofluoresent signals were hypo-reflective. These findings suggest that autofluorescent reflections are derived from the retinal pigment epithelium (RPE) and outer retinal- RPE adhesion is a requisite for physiological RPE function.

Conclusions:

Chronic far peripheral retinal detachments without snowflakes can be difficult to distinguish from retinoschisis. Wide-field autofluorescence imaging is a non-invasive, objective and simple technique to differentiate retinoschisis from retinal detachments.

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