First Author: S.M.Caprani ITALY
Co Author(s): S. Donati E. Gibin C. Gandolfi C. Azzolini 0 0 0 0 0 0 0 0 0
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To evaluate macular morphology after vitreo-surgery for retinal detachment and the related-progressive visual function.
Retrospective interventional study Department of Surgical and Morphological Sciences - Section of Ophthalmology, University of Insubria- Ospedale di Circolo- Varese- Italy
This retrospective interventional study included consecutive 26 eyes of 26 patients affected by rhegmatogenous retinal detachment who underwent vitreoretinal surgery. Exclusion criteria considered patients affected by diabetic retinopathy, retinal vascular occlusion and posterior uveitis. Baseline and follow up evaluations at month 1, 3 and 6 included complete ophthalmic, instrumental examination and a complete clinical history. Functional evaluation was performed by ETDRS visual acuity and Amsler test. Morphological evaluation was performed by a deep analysis of retinal layers and vitreoretinal interface as well as retinal thickness with SD OCT. A standard vitreoretinal surgery was performed completed by C3F8 gas endotamponade, laser photocoagulation and/or criopexy. Statistical analysis was performed on collected data.
Macular morphology examination presented different and evolutive features. Presurgical data showed 21 eyes with macular region involvement, 9 eyes with less than 1 peripheral retinal quadrant involved, 17 with more than 2 quadrant involved. Post surgical parameters SD-OCT examination showed a mean retinal thickness of 287,4 µm at month 3, 293.2 µm at month 6. Intraretinal cyts and/or subretinal fluid was diagnosed in 15 eyes at month 1, in 10 eyes at month 3 and 4 patients at month 6; the presence of epiretinal membrane in one eye at month 1, in 5 eyes at month 3, in 7 eyes at month 6. Mean VA was 0,69±0,52 logMAR at baseline, 0.6±0.9 logMAR at month 1, 0.35±0.52 logMAR at month 3, 0.36± 0.71 logMAR at month 6. Persistence of visual methamorphopsia were reported by 12 patients at month 3 and by 6 patients at month 6.
The presence or the persistence of macular edema and epiretinal or intraretinal alteration could influence seriously the visual recovery during follow up. Visual acuity as well as metamorphopsia and relative scotoma represents the main features of these disorders. Nowadays SD-OCT allows to early identify and analyze epiretinal and intraretinal layers integrity for a prompt therapy. We underline that not only preoperative foveal status but also surgical manoeuvres and devices have an important responsibility.