Cellular Characterization of OCT and Outer Retinal Bands Using Specific Immunohistochemistry Markers and Clinical Implications

Purpose of reviewUpdate on controversies in the surgical management of rhegmatogenous retinal detachment.Recent findingsThere are multiple new reports regarding the development and management of retinal detachment. Current use of oral fluoroquinolones may be associated with onset of retinal detachme

Update on retinal detachment surgery.

Purpose: To compare the efficacy of pars plana vitrectomy (PPV) with that of scleral buckling (SB) in the treatment of uncomplicated, primary rhegmatogenous retinal detachment (RRD).Materials and methods: Meta-analysis of randomized controlled trials (RCTs) were performed. Phakic and pseudophakic/aphakic eyes were analyzed separately. Searches of PUBMED, EMBASE, and the Cochrane Central Register of Controlled Trials were conducted. Outcome measures included primary and final anatomic success, final visual success, and development of post-operative proliferative vitreoretinopathy (PVR) and/or post-operative cataract.Results: Three RCTs of phakic eyes (n = 523) and four RCTs of pseudophakic/aphakic eyes (n = 690) were included in the meta-analysis. For the phakic group, searches of PPV and SB yielded similar results in terms of primary/final retinal re-attachment and post-operative PVR. In the SB arm, visual acuity (VA) was better (heterogeneity p = 0.14; OR = 0.50, 95%CI, 0.31–0.82; p = 0.005) and the rate...

Primary vitrectomy versus scleral buckling for the treatment of rhegmatogenous retinal detachment: a meta-analysis of randomized controlled clinical trials.

Purpose:To evaluate preoperative factors influencing the visual outcome and postoperative factors associated with the changes in visual acuity, after reattachment surgery to treat macula-off rhegmatogenous retinal detachment.Methods:A total of 180 eyes of 180 patients who underwent reattachment surg

Factors associated with visual outcome after macula-off rhegmatogenous retinal detachment surgery.

PURPOSE To investigate the foveal changes after repair of macula-off rhegmatogenous retinal detachment (RRD). METHODS Prospective comparative case series. Twenty-four eyes of 24 patients with macula-off/fovea-on detachment (n = 9) and fovea-off detachment (n = 15) were studied. Serial optical coherence tomography (OCT) images taken at the same location were recorded at months 1, 3, 6, and 12 after operation. Fellow eyes were used as controls. RESULTS No significant changes of the central foveal thickness (CFT) were recorded in the fovea-on group over the follow-up. From month 1 to month 12, CFT increased significantly in the fovea-off group (P < 0.00001). In this group, a significant increase of the Henle fiber and outer nuclear layer (HFL + ONL, P = 0.007), external limiting membrane (ELM)-ellipsoid zone (EZ; P = 0.03), and EZ-retinal pigment epithelium (RPE) thicknesses (P < 0.00001) was recorded. Significant restoration of the integrity of the ELM in the fovea-off group (P < 0.001) and of the EZ and cone interdigitation zone in the fovea-on group and the fovea-off group was observed (P = 0.02 and P < 0.001, and P = 0.002 and P < 0.001, respectively). Twelve months after operation the foveal bulge restored in 8 of 15 eyes of the fovea-off group. Multiple regression analysis showed that in the fovea-off group BCVA correlated with EZ-RPE thickness at months 1 and 12, whereas the improvement of BCVA during the 12 months follow-up correlated with the increase of ELM-RPE thickness. CONCLUSIONS Optical coherence tomography scans taken serially at the same location showed a progressive increase of HNL+ONL, ELM-EZ, and EZ-RPE thicknesses and restoration of the integrity of outer retinal bands after repair of fovea-off RRD. The use of software able to rescan at exactly the same area is crucial to correctly follow and interpret the reconstitution of the retinal bands and to correlate them to BCVA recovery.

Restoration of foveal thickness and architecture after macula-off retinal detachment repair.

Purpose:To correlate the postoperative visual outcome with the spectral-domain optical coherence tomography (SD-OCT) findings in the fovea after successful rhegmatogenous retinal detachment repair. Cross-sectional, observational study.Methods:Thirty-five patients with preoperative macula-on rhegmato

Mariacristina Esposito

Papers

Correlation between spectral-domain optical coherence tomography findings and visual outcome after primary rhegmatogenous retinal detachment repair.