OCT Assistance in Identifying Retinal Breaks in Symptomatic Posterior Vitreous Detachments

Ansari, Waseem; Blackorby, Barton L.; Shah, Gaurav K.; Blinder, Kevin J.; Dang, Sabin

doi:10.3928/23258160-20201104-04

Cited by 3 publications

(7 citation statements)

References 8 publications

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“…In a study of donor eyes, Wang et al reported an increase in age-related migration of the posterior border of the vitreous base in men compared with women. 15 In addition, previous studies 11,16,17 have reported trends of retinal tears in younger patients; however, our study found there was a significant association between the two.…”

Section: Discussioncontrasting

confidence: 77%

“…However, only few studies have evaluated OCT imaging correlates of retinal tear in acute PVD. 11,16,23 The most recent study by Ansari et al evaluated 78 patients and found the presence of PVOs has a sensitivity and specificity of 76% and 75.5%, respectively, in detecting retinal tears in patients with symptomatic PVD. Negative predictive value and PPV were 87% and 59.4%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…10 Of note, OCT has also recently shown promise in detecting an emerging imaging correlate of retinal tears in the form of posterior vitreous opacities (PVO), believed to represent erythrocytes from vitreous hemorrhage or liberated retinal pigment epithelial cells. 11 Here, we aim to similarly evaluate the association of findings of PVOs on OCT with tears identified on fundus photographs and on examination, in patients with acute, symptomatic PVD.…”

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confidence: 99%

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Use of Optical Coherence Tomography in Detecting Retinal Tears in Acute, Symptomatic Posterior Vitreous Detachment

Rao¹,

Shah²,

Nguyen³

et al. 2023

Retina

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To evaluate the association of posterior vitreous opacities (PVOs) on optical coherence tomography with retinal tears identified on examination in patients with acute, symptomatic posterior vitreous detachment (PVD).Methods: Data were retrospectively collected from the medical records of 388 patients with acute, symptomatic PVD between January 1, 2021, and June 30, 2021. Included patients had received a primary diagnosis of PVD and presented with flashes and/or floaters. Optical coherence tomography scans were reviewed by two separate readers for the presence of PVOs. The primary outcome was the presence of retinal tear on fundus photograph and on examination.Results: Of 388 patients who presented with acute PVD symptoms, 90 (23.2%) were found to have a retinal tear on dilated fundus examination. Among these patients, 78 (86.7%) were found to have PVOs on optical coherence tomography. Statistical analysis demonstrated a significant relationship between the presence of PVOs and retinal tear (P , 0.01). The sensitivity and specificity of this finding was 86.7% and 72.5%, respectively. Further analysis included area under the curve from receiver operating characteristic curve which was found to be 0.80. Conclusion:The presence of PVOs on optical coherence tomography is suggestive of a retinal tear in patients with acute, symptomatic PVD.

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Section: Discussioncontrasting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Use of Optical Coherence Tomography in Detecting Retinal Tears in Acute, Symptomatic Posterior Vitreous Detachment

Rao¹,

Shah²,

Nguyen³

et al. 2023

Retina

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“…The standard of care is to carefully observe the entire retina with ophthalmoscopy and scleral depression for the presence of breaks. However, clinical diagnosis is not perfect and OCT may be superior for identification of peripheral pathology ( 32 , 33 ). In this paper, we have presented several examples of tractional, rhegmatogenous, and exudative detachments and highlighted ways in which WF-OCT may be utilized in the diagnosis and monitoring of these diseases in the future.…”

Section: Discussionmentioning

confidence: 99%

Widefield Optical Coherence Tomography in Pediatric Retina: A Case Series of Intraoperative Applications Using a Prototype Handheld Device

Nguyen

Liang

et al. 2022

Front. Med.

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Optical coherence tomography (OCT) has changed the standard of care for diagnosis and management of macular diseases in adults. Current commercially available OCT systems, including handheld OCT for pediatric use, have a relatively narrow field of view (FOV), which has limited the potential application of OCT to retinal diseases with primarily peripheral pathology, including many of the most common pediatric retinal conditions. More broadly, diagnosis of all types of retinal detachment (exudative, tractional, and rhegmatogenous) may be improved with OCT-based assessment of retinal breaks, identification of proliferative vitreoretinopathy (PVR) membranes, and the pattern of subretinal fluid. Intraocular tumors both benign and malignant often occur outside of the central macula and may be associated with exudation, subretinal and intraretinal fluid, and vitreoretinal traction. The development of wider field OCT systems thus has the potential to improve the diagnosis and management of myriad diseases in both adult and pediatric retina. In this paper, we present a case series of pediatric patients with complex vitreoretinal pathology undergoing examinations under anesthesia (EUA) using a portable widefield (WF) swept-source (SS)-OCT device.

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“…Notably, the absence of clinical vitreous hemorrhage and VHRDs indicated a 94% chance that no retinal breaks were present. 4 Thus, a “negative” or normal SD-OCT imaging in setting of an acute PVD seems to have a strong negative predictive value for a peripheral rhegmatogenous event, especially if paired with conventional ophthalmoscopy with scleral depression.…”

Section: Vitreous Hyperreflective Dots As Biomarker Of a Rhegmatogeno...mentioning

confidence: 97%

Role of Optical Coherence Tomography in Management of Acute Posterior Vitreous Detachment and Its Complications

Wang

Lovenberg

Hess

et al. 2023

Retina

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Purpose: Currently, no consensus exists on the role of optical coherence tomography (OCT) imaging in the setting of acute posterior vitreous detachment (PVD). The authors outline the clinical utility of OCT in the management of acute PVD and its complications.Methods: Literature review of OCT findings in association with acute PVD and report of illustrative cases.Results: Optical coherence tomography imaging in the setting of acute PVD can provide details of vitreoretinal interface that are difficult to appreciate on biomicroscopy alone including partial PVDs, focal vitreoretinal adhesions and traction, and subclinical macular changes. The presence of vitreous hyperreflective dots on OCT in the premacular space, especially if severe, is highly correlated with the presence of peripheral retinal breaks and development of epiretinal membrane. Advancements in OCT technology, including enhanced vitreous imaging OCT, swept-source OCT, wide-angle OCT, and widefield OCT, allow for increased resolution and expanded field of imaging of the vitreoretinal interface.Conclusion: Optical coherence tomography imaging is an emerging standard of care in the setting of patients presenting with new flashes and floaters. The authors highlight the benefits of OCT imaging in patients with acute PVD, which includes recognition of the status of the vitreoretinal interface, assistance in identifying high-risk PVDs, and performance of risk assessment that predict future macular pathologic condition.

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OCT Assistance in Identifying Retinal Breaks in Symptomatic Posterior Vitreous Detachments

Cited by 3 publications

References 8 publications

Use of Optical Coherence Tomography in Detecting Retinal Tears in Acute, Symptomatic Posterior Vitreous Detachment

Use of Optical Coherence Tomography in Detecting Retinal Tears in Acute, Symptomatic Posterior Vitreous Detachment

Widefield Optical Coherence Tomography in Pediatric Retina: A Case Series of Intraoperative Applications Using a Prototype Handheld Device

Role of Optical Coherence Tomography in Management of Acute Posterior Vitreous Detachment and Its Complications

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