Macular morphologic changes following successful retinal detachment repair by scleral buckling surgery
Abstract
Background/Aim. Spectral domain optical coherence tomography (SDOCT) is very useful for the accurate examination of macular microstructure. The aim of this study was to evaluate macular morphologic changes after successful retinal detachment (RD) surgery by scleral buckling (SB) using SDOCT and assess their impact on vision repair. Methods. SDOCT examination was performed in 1, 6, and 12 months in 27 eyes following SB surgery with the successful anatomical repair of rhegmatogenous RD, which also affected the macular region. The examination was performed in a 6 mm diameter central macular region and included measurements of the central foveal thickness, average total retinal thickness (TRT), and thickness of the inner and outer retinal layer (ORT) separately. The numerical values of parameters for each operated eye were compared with those of the fellow (control) eye of each patient. The condition of the external limiting membrane (ELM) and inner segment (IS) and outer segment (OS) of the photoreceptors was also examined. Results. The mean TRT and ORT in the reattached regions in the operated eyes were significantly thinner than the corresponding regions of the fellow (control) eye, and throughout the follow-up period, the difference was statistically significant. There was a statistically significant difference in TRT (after 1 month, p = 0.021, after 6 months, p = 0.026, after 12 months, p = 0.027) and ORT (after 1 month, p = 0.018, after 6 months, p = 0.019, after 12 months, p = 0.021) between the eyes with a longer preoperative duration of macular detachment (MD) of 2 weeks and eyes with shorter detachment period. Disruptions of the IS and OS of photoreceptors and ELM on SDOCT examination after one month were observed in 37.04% of eyes, after 6 months in 29.6% of eyes, and at the end of the follow-up period in 14.8% of eyes. A statistically significant difference was found in the frequency of disruptions of the IS and OS, and ELM depending on the preoperative duration of RD (p = 0.007). Conclusion. The overall decrease in the mean retinal thickness after successful anatomical repair of RD is the result of a decrease in the thickness of the outer retinal layers. The alterations of the ELM, IS and OS of photoreceptors observed on the early SDOCT scans are mostly associated with limited vision recovery. The prolonged MD leads to damaging the neurosensory tissue of the retina and especially the photoreceptors, which may explain the limited visual acuity recovery after successful SB repair of RD
References
800x600
Normal
0
false
false
false
EN-US
X-NONE
X-NONE
MicrosoftInternetExplorer4
DefSemiHidden="false" DefQFormat="false" DefPriority="99"
LatentStyleCount="371">
UnhideWhenUsed="true" QFormat="true" Name="heading 2"/>
UnhideWhenUsed="true" QFormat="true" Name="heading 3"/>
UnhideWhenUsed="true" QFormat="true" Name="heading 4"/>
UnhideWhenUsed="true" QFormat="true" Name="heading 5"/>
UnhideWhenUsed="true" QFormat="true" Name="heading 6"/>
UnhideWhenUsed="true" QFormat="true" Name="heading 7"/>
UnhideWhenUsed="true" QFormat="true" Name="heading 8"/>
UnhideWhenUsed="true" QFormat="true" Name="heading 9"/>
Name="index 1"/>
Name="index 2"/>
Name="index 3"/>
Name="index 4"/>
Name="index 5"/>
Name="index 6"/>
Name="index 7"/>
Name="index 8"/>
Name="index 9"/>
UnhideWhenUsed="true" Name="toc 1"/>
UnhideWhenUsed="true" Name="toc 2"/>
UnhideWhenUsed="true" Name="toc 3"/>
UnhideWhenUsed="true" Name="toc 4"/>
UnhideWhenUsed="true" Name="toc 5"/>
UnhideWhenUsed="true" Name="toc 6"/>
UnhideWhenUsed="true" Name="toc 7"/>
UnhideWhenUsed="true" Name="toc 8"/>
UnhideWhenUsed="true" Name="toc 9"/>
Name="Normal Indent"/>
Name="footnote text"/>
Name="annotation text"/>
Name="header"/>
Name="footer"/>
Name="index heading"/>
UnhideWhenUsed="true" QFormat="true" Name="caption"/>
Name="table of figures"/>
Name="envelope address"/>
Name="envelope return"/>
Name="footnote reference"/>
Name="annotation reference"/>
Name="line number"/>
Name="page number"/>
Name="endnote reference"/>
Name="endnote text"/>
Name="table of authorities"/>
Name="macro"/>
Name="toa heading"/>
Name="List"/>
Name="List Bullet"/>
Name="List Number"/>
Name="List 2"/>
Name="List 3"/>
Name="List 4"/>
Name="List 5"/>
Name="List Bullet 2"/>
Name="List Bullet 3"/>
Name="List Bullet 4"/>
Name="List Bullet 5"/>
Name="List Number 2"/>
Name="List Number 3"/>
Name="List Number 4"/>
Name="List Number 5"/>
Name="Closing"/>
Name="Signature"/>
UnhideWhenUsed="true" Name="Default Paragraph Font"/>
Name="Body Text"/>
Name="Body Text Indent"/>
Name="List Continue"/>
Name="List Continue 2"/>
Name="List Continue 3"/>
Name="List Continue 4"/>
Name="List Continue 5"/>
Name="Message Header"/>
Name="Salutation"/>
Name="Date"/>
Name="Body Text First Indent"/>
Name="Body Text First Indent 2"/>
Name="Note Heading"/>
Name="Body Text 2"/>
Name="Body Text 3"/>
Name="Body Text Indent 2"/>
Name="Body Text Indent 3"/>
Name="Block Text"/>
Name="Hyperlink"/>
Name="FollowedHyperlink"/>
Name="Document Map"/>
Name="Plain Text"/>
Name="E-mail Signature"/>
Name="HTML Top of Form"/>
Name="HTML Bottom of Form"/>
Name="Normal (Web)"/>
Name="HTML Acronym"/>
Name="HTML Address"/>
Name="HTML Cite"/>
Name="HTML Code"/>
Name="HTML Definition"/>
Name="HTML Keyboard"/>
Name="HTML Preformatted"/>
Name="HTML Sample"/>
Name="HTML Typewriter"/>
Name="HTML Variable"/>
Name="Normal Table"/>
Name="annotation subject"/>
Name="No List"/>
Name="Outline List 1"/>
Name="Outline List 2"/>
Name="Outline List 3"/>
Name="Table Simple 1"/>
Name="Table Simple 2"/>
Name="Table Simple 3"/>
Name="Table Classic 1"/>
Name="Table Classic 2"/>
Name="Table Classic 3"/>
Name="Table Classic 4"/>
Name="Table Colorful 1"/>
Name="Table Colorful 2"/>
Name="Table Colorful 3"/>
Name="Table Columns 1"/>
Name="Table Columns 2"/>
Name="Table Columns 3"/>
Name="Table Columns 4"/>
Name="Table Columns 5"/>
Name="Table Grid 1"/>
Name="Table Grid 2"/>
Name="Table Grid 3"/>
Name="Table Grid 4"/>
Name="Table Grid 5"/>
Name="Table Grid 6"/>
Name="Table Grid 7"/>
Name="Table Grid 8"/>
Name="Table List 1"/>
Name="Table List 2"/>
Name="Table List 3"/>
Name="Table List 4"/>
Name="Table List 5"/>
Name="Table List 6"/>
Name="Table List 7"/>
Name="Table List 8"/>
Name="Table 3D effects 1"/>
Name="Table 3D effects 2"/>
Name="Table 3D effects 3"/>
Name="Table Contemporary"/>
Name="Table Elegant"/>
Name="Table Professional"/>
Name="Table Subtle 1"/>
Name="Table Subtle 2"/>
Name="Table Web 1"/>
Name="Table Web 2"/>
Name="Table Web 3"/>
Name="Balloon Text"/>
Name="Table Theme"/>
Name="List Paragraph"/>
Name="Intense Quote"/>
Name="Subtle Emphasis"/>
Name="Intense Emphasis"/>
Name="Subtle Reference"/>
Name="Intense Reference"/>
UnhideWhenUsed="true" Name="Bibliography"/>
UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>
Name="Grid Table 1 Light Accent 1"/>
Name="Grid Table 6 Colorful Accent 1"/>
Name="Grid Table 7 Colorful Accent 1"/>
Name="Grid Table 1 Light Accent 2"/>
Name="Grid Table 6 Colorful Accent 2"/>
Name="Grid Table 7 Colorful Accent 2"/>
Name="Grid Table 1 Light Accent 3"/>
Name="Grid Table 6 Colorful Accent 3"/>
Name="Grid Table 7 Colorful Accent 3"/>
Name="Grid Table 1 Light Accent 4"/>
Name="Grid Table 6 Colorful Accent 4"/>
Name="Grid Table 7 Colorful Accent 4"/>
Name="Grid Table 1 Light Accent 5"/>
Name="Grid Table 6 Colorful Accent 5"/>
Name="Grid Table 7 Colorful Accent 5"/>
Name="Grid Table 1 Light Accent 6"/>
Name="Grid Table 6 Colorful Accent 6"/>
Name="Grid Table 7 Colorful Accent 6"/>
Name="List Table 1 Light Accent 1"/>
Name="List Table 6 Colorful Accent 1"/>
Name="List Table 7 Colorful Accent 1"/>
Name="List Table 1 Light Accent 2"/>
Name="List Table 6 Colorful Accent 2"/>
Name="List Table 7 Colorful Accent 2"/>
Name="List Table 1 Light Accent 3"/>
Name="List Table 6 Colorful Accent 3"/>
Name="List Table 7 Colorful Accent 3"/>
Name="List Table 1 Light Accent 4"/>
Name="List Table 6 Colorful Accent 4"/>
Name="List Table 7 Colorful Accent 4"/>
Name="List Table 1 Light Accent 5"/>
Name="List Table 6 Colorful Accent 5"/>
Name="List Table 7 Colorful Accent 5"/>
Name="List Table 1 Light Accent 6"/>
Name="List Table 6 Colorful Accent 6"/>
Name="List Table 7 Colorful Accent 6"/>
/* Style Definitions */
table.MsoNormalTable
{mso-style-name:"Table Normal";
mso-tstyle-rowband-size:0;
mso-tstyle-colband-size:0;
mso-style-noshow:yes;
mso-style-priority:99;
mso-style-parent:"";
mso-padding-alt:0cm 5.4pt 0cm 5.4pt;
mso-para-margin:0cm;
mso-para-margin-bottom:.0001pt;
mso-pagination:widow-orphan;
font-size:10.0pt;
font-family:"Times New Roman",serif;}
1. Burton TC. Recovery of visual acuity after retinal detachment involving the macula. Trans Am Ophthalmol Soc 1982; 80: 475–97.
2. Kusaka S, Toshino A, Ohashi Y, Sakaue E. Long-term visual recovery after scleral buckling for macula-off retinal detachments. Jpn J Ophthalmol 1998; 42(3): 218–22.
3. Pastor JC, Fernández I, Rodríguez de la Rúa E, Coco R, Sanabria-Ruiz Colmenares MR, Sánchez-Chicharro D, et al. Surgical outcomes for primary rhegmatogenous retinal detachments in phakic and pseudophakic patients: the Retina 1 Project--report 2. Br J Ophthalmol 2008; 92(3): 378‒82.
4. Cheng KC, Cheng KY, Cheng KH, Chen KJ, Chen CH, Wu WC. Using optical coherence tomography to evaluate macular changes after surgical management for rhegmatogenous retinal detachment. Kaohsiung J Med Sci 2016; 32(5): 248‒54.
5. Wolfensberger TJ, Gonvers M. Optical coherence tomography in the evaluation of incomplete visual acuity recovery after macula-off retinal detachments. Graefes Arch Clin Exp Ophthalmol 2002; 240(2): 85‒9.
6. Ricker LJ, Noordzij LJ, Goezinne F, Cals DW, Berendschot TT, Liem AT, et al. Persistent subfoveal fluid and increased preoperative foveal thickness impair visual outcome after macula-off retinal detachment repair. Retina 2011; 31(8): 1505–12.
7. Farooq S, Mahsood YJ, Jan S. Optical Coherence Tomography: Macular findings after successful sclera buckling in eyes with compromised visual status. J Coll Physicians Surg Pak 2018; 28(4): 297‒300.
8. Sakai T, Calderone JB, Lewis GP, Linberg KA, Fisher SK, Jacobs GH. Cone photoreceptor recovery after experimental detachment and reattachment: an immunocytochemical, morphological, and electrophysiological study. Invest Ophthalmol Vis Sci 2003; 44(1): 416–25.
9. Lewis GP, Charteris DG, Sethi CS, Leitner WP, Linberg KA, Fisher SK. The ability of rapid retinal reattachment to stop or reverse the cellular and molecular events initiated by detachment. Invest Ophthalmol Vis Sci 2002; 43(7): 2412–20.
10. Barr CC. The histopathology of successful retinal reattachment. Retina 1990; 10(3): 189–94.
11. Rashid S, Pilli S, Chin EK, Zawadzki RJ, Werner JS, Park SS. Five‑year follow‑up of macular morphologic changes after rhegmatogenous retinal detachment repair: Fourier domain OCT findings. Retina 2013; 33(10): 2049‒58.
12. Wakabayashi T, Oshima Y, Fujimoto H, Murakami Y, Sakaguchi H, Kusaka S, et al. Foveal microstructure and visual acuity after retinal detachment repair: Imaging analysis by Fourier‑domain optical coherence tomography. Ophthalmology 2009; 116(3): 519‒28.
13. Kim JH, Park DY, Ha HS, Kang SW. Topographic changes of retinal layers after resolution of acute retinal detachment. Invest Ophthalmol Vis Sci 2012; 53(11): 7316‒21.
14. Arroyo JG, Yang L, Bula D, Chen DF. Photoreceptor apoptosis in human retinal detachment. Am J Ophthalmol 2005; 139(4): 605–10.
15. Alam S, Zawadzki RJ, Choi S, Gerth C, Park SS, Morse L, et al. Clinical application of rapid serial Fourier-domain optical coherence tomography for macular imaging. Ophthalmology 2006; 113(8): 1425–31.
16. Guerin CJ, Anderson DH, Fariss RN, Fisher SK. Retinal reattachment of the primate macula. Photoreceptor recovery after short-term detachment. Invest Ophthalmol Vis Sci 1989; 30(8): 1708–25.
17. Faude F, Francke M, Makarov F, Schuck J, Gärtner U, Reichelt W, et al. Experimental retinal detachment causes widespread and multilayered degeneration in rabbit retina. J Neurocytol 2001; 30(5): 379‒90.
18. Lewis GP, Charteris DG, Sethi CS, Fisher SK. Animal models of retinal detachment and reattachment: identifying cellular events that may affect visual recovery. Eye (Lond) 2002; 16(4): 375‒87.
19. Guerin CJ, Lewis GP, Fisher SK, Anderson DH. Recovery of photoreceptor outer segment length and analysis of membrane assembly rates in regenerating primate photoreceptor outer segments. Invest Ophthalmol Vis Sci. 1993; 34(1): 175–83.
20. Cook B, Lewis GP, Fisher SK, Adler R. Apoptotic photoreceptor degeneration in experimental retinal detachment. Invest Ophthalmol Vis Sci 1995; 36(6): 990–6.
21. Murakami Y, Notomi S, Hisatomi T, Nakazawa T, Ishibashi T, Miller JW, et al. Photoreceptor cell death and rescue in retinal detachment and degenerations. Prog Retin Eye Res 2013; 37: 114‒40.
22. Takkar B, Azad R, Kamble N, Azad S. Retinal nerve fiber layer changes following primary retinal detachment repair with silicone oil tamponade and subsequent oil removal. J Ophthalmic Vis Res 2018; 13(2): 124–9.
23. Akkoyun I, Yilmaz G. Optical coherence tomography: Anatomic and functional outcome after scleral buckling surgery in macula‑off rhegmatogenous retinal detachment. Klin Monbl Augenheilkd 2013; 230(8): 814‒9. (German)
24. Diederen RM, La Heij EC, Kessels AG, Goezinne F, Liem AT, Hendrikse F. Scleral buckling surgery after macula-off retinal detachment: worse visual outcome after more than 6 days. Ophthalmology 2007; 114(4): 705–9.
25. Liu F, Meyer CH, Mennel S, Hoerle S, Kroll P. Visual recovery after scleral buckling surgery in macula-off rhegmatogenous retinal detachment. Ophthalmologica 2006; 220(3): 174–80.
26. Anderson DH, Guerin CJ, Erickson PA, Stern WH, Fisher SK. Morphological recovery in the reattached retina. Invest Ophthalmol Vis Sci 1986; 27(2): 168–83.
27. Lai WW, Leung GY, Chan CW, Yeung IY, Wong D. Simultaneous spectral domain OCT and fundus autofluorescence imaging of the macula and microperimetric correspondence after successful repair of rhegmatogenous retinal detachment. Br J Ophthalmol 2010; 94(3): 311–8.
28. Sheth S, Dabir S, Natarajan S, Mhatre A, Labauri N. Spectral domain-optical coherence tomography study of retinas with a normal foveal contour and thickness after retinal detachment surgery. Retina 2010; 30(5): 724–32.
29. Rossetti A, Doro D, Manfrè A, Midena E. Long-term follow-up with optical coherence tomography and microperimetry in eyes with metamorphopsia after macula-off retinal detachment repair. Eye 2010; 24(12): 1808–13.
30. Spaide RF, Curcio CA. Anatomical correlates to the bands seen in the outer retina by optical coherence tomography. Retina 2011; 31(8): 1609–19.
31. Gharbiya M, Albanese GM, Plateroti AM, Marcelli M, Marenco M, Lambiase A. Macular ganglion cell layer thickness after macula-off rhegmatogenous retinal detachment repair: scleral buckling versus pars plana vitrectomy. J Clin Med 2020; 9(5): 1411.
32. Lee SH, Han JW, Byeon SH, Kim SS, Koh HJ, Lee SC, et al. Retinal layer segmentation after silicone oil or gas tamponade for macula-on retinal detachment using optical coherence tomography. Retina 2018; 38(2): 310–9.
33. Lee YH, Lee JE, Shin YI, Lee KM, Jo YJ, Kim JY. Longitudinal changes in retinal nerve fiber layer thickness after vitrectomy for rhegmatogenous retinal detachment. Invest Ophthalmol Vis Sci 2012; 53(9): 5471–4.
34. Menke MN, Kowal JH, Dufour P, Wolf-Schnurrbusch UE, Ceklic L, Framme C, et al. Retinal layer measurements after successful macula-off retinal detachment repair using optical coherence tomography. Invest Ophthalmol Vis Sci 2014; 55(10): 6575–9.
35. Ozdek S, Lonneville Y, Onol M, Gurelik G, Hasanreisoglu B. Assessment of retinal nerve fiber layer thickness with NFA-GDx following successful scleral buckling surgery. Eur J Ophthalmol 2003; 13(8): 697‒701.
36. Hagimura N, Iida T, Suto K, Kishi SL. Persistent foveal retinal detachment after successful rhegmatogenous retinal detachment surgery. Am J Ophthalmol 2002; 133(4): 516–20.
37. Yoshida A, Hirokawa H, Ishiko S, Ogasawara H. Ocular circulatory changes following scleral buckling procedures. Br J Ophthalmol 1992; 76(9): 529‒31.
38. Takahashi K, Kishi S. Remodeling of choroidal venous drainage after vortex vein occlusion following scleral buckling for retinal detachment. Am J Ophthalmol 2000; 129(2): 191‒8.
39. Lira RP, Takasaka I, Arieta CE, Nascimento MA, Caldato R, Panetta H. Cryotherapy vs laser photocoagulation in scleral buckle surgery: A randomized clinical trial. Arch Ophthalmol 2010; 128(12): 1519‒22.
40. Kimura M, Nishimura A, Yokogawa H, Okuda T, Higashide T, Saito Y, et al. Subfoveal choroidal thickness change following segmental scleral buckling for rhegmatogenous retinal detachment. Am J Ophthalmol 2012; 154(5): 893‒900.
41. Lee SY, Joe SG, Kim JG, Chung H, Yoon YH. Optical coherence tomography evaluation of detached macula from rhegmatogenous retinal detachment and central serous chorioretinopathy. Am J Ophthalmol 2008; 145(6): 1071‒6.
42. Zhou C, Lin Q, Chen F. Prevalence and predictors of metamorphopsia after successful rhegmatogenous retinal detachment surgery: a crossectional, comparative study. Br J Ophthalmol 2017; 101(6): 725‒9.
43. Gibran SK, Cleary PE. Ocular coherence tomographic examination of postoperative foveal architecture after scleral buckling vs vitrectomy for macular off retinal detachment. Eye (Lond) 2007; 21(9): 1174–8.
44. Williamson TH, Shunmugam M, Rodrigues I, Dogramaci M, Lee E. Characteristics of rhegmatogenous retinal detachment and their relationship to visual outcome. Eye (Lond) 2013; 27: 1063‒9.