97th DOG Annual Meeting 1999
RHEGMATOGENOUS RETINAL DETACHMENT INVOLVING FOVEA: OPTICAL COHERENCE TOMO-GRAPHY (OCT) OF MACULA FOLLOWING EXTRAOCULAR SURGERY
W. Inhoffen, M. Partsch, F. Gelisken, I. Kreissig
Introduction: Macular structures in the vertical direction can be revealed by Optical Coherence Tomography (OCT, resolution 12 µm). Therefore, we examined the appliciability of the OCT for measuring delayed central retinal resorption after treatment of retinal detachment.
Methods: The height of the foveal detachment of 11 patients with rhegmatogenous detachment involving the fovea was measured postoperatively by means of OCT (time of measurement: 3 days to 1.5 years). After extraocular minimal detachment surgery without drainage the retina was attached peripherally without new holes. Three patients had funduscopic signs of delayed central retinal resorption (Group a). Five patients showed postoperatively attached fovea but had metamorphopsia or insufficient visual improvement (Group b). Three patients had no signs of delayed central resorption and showed significant improvement of visual acuity (Group c).
Results: Group a: The height of the foveal detachment vs. time postoperatively showed a linear behavior with decreasing detachment. Thus, the time for reattachment of the fovea could be foreseen after 2 measurements at different times. The rate of decrease in foveal distance to the pigment epithelium was 16 to 50 µm/month. Group b: One patient revealed a small foveal detachment (height<50µm, diameter < 0.2 PD), not visible funduscopically. This might explain metamorphosia and micropsia. In another patient with metamorphopsia, the foveal pit was asymmetric. Two patients showed localized regions with small detachments around the fovea, which resolved after appr. 3/4 year. One patient had no signs of abnormal macula by OCT examination. Thus, only small improvement of vision was due to longstanding detachment before treatment. Group c: Foveal detachment within the first days after treatment was not visible by funduscopy, but could be measured by OCT. These detachments resolved within one week and resulted in visual improvement.
Conclusions: In rhegmatogenous retinal detachment including the fovea, the behaviour of the central retina after treatment can be examined by OCT measurement of the foveal detachment more precisely as by funduscopic examination.
Univ.-Eye Clinic Tuebingen, Department of Ophthalmology III: Retina and Vitreous Surgery, Schleichstr. 12, D-72076 Tuebingen, Germany