Early Simultaneous Fundus Autofluorescence and Optical Coherence Tomography Features After Pars Plana Vitrectomy for Primary Rhegmatogenous Retinal Detachment

Abstract

Partial-thickness retinal folds occur commonly after vitrectomy for rhegmatogenous retinal detachment repair and may represent an important anatomical substrate for postoperative metamorphopsia. Fundus autofluorescence and OCT are both sensitive techniques for the detection of these abnormalities.

Evolution of Outer Retinal Folds Occurring after Vitrectomy for Retinal Detachment Repair

“…On the basis of previous OCT reports 15 and our observations, 14 we believe that hypothesis 3 is the most likely.…”

“…ORFs must be differentiated from full-thickness retinal folds, which involve all retinal layers and may also occur after successful repair of RD. 16 Another interesting feature observed in our previous study 14 consisted of sharply demarcated skip changes in reflectivity of the inner segment/outer segment (IS/OS) line on OCT corresponding to thin lines of increased autofluorescence on FAF (Fig. 2).…”

“…For such reason, in a previous paper 14 we deemed appropriate to refer to these abnormalities as ''outer retinal folds'' (ORFs). ORFs must be differentiated from full-thickness retinal folds, which involve all retinal layers and may also occur after successful repair of RD.…”

“…14 Differently from RVPs, other lines of abnormal autofluorescence, showing no relationships with the adjacent retinal vessels and having characteristic counterparts on OCT, can also commonly occur after RD repair (Figs. 1, 2).…”

“…4,5 The advent of spectral domain-optical coherence tomography (sd-OCT) has permitted, without invasive intervention, to acquire pathologic data in vivo showing that persistent foveal detachment, distortion, and disruption of outer retinal layers (ORLs) and macular folds are common findings following successful surgery for retinal detachment (RD). [6][7][8][9][10][11][12][13][14] More recently, fundus autofluorescence (FAF), an imaging modality that relies primarily on the fluorescence generated from the bisretinoids of lipofuscin in retinal pigment epithelial cells, also has been used to investigate the morphologic and functional changes occurring after RD repair. Shiragami et al 13 showed that in patients with large, bullous RDs, shifting of the retina from its original position can frequently be observed after vitrectomy and is elegantly depicted by FAF.…”