Regeneration of Photoreceptor Outer Segments After Scleral Buckling Surgery for Rhegmatogenous Retinal Detachment

Ra, Eimei; Ito, Yasuki; Kawano, Kenichi; Iwase, Takeshi; Kaneko, Hiroki; Ueno, Shinji; Yasuda, Shunsuke; Kataoka, Keiko; Terasaki, Hiroko

doi:10.1016/j.ajo.2017.01.032

Cited by 28 publications

(22 citation statements)

References 45 publications

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“…However, our results should be interpreted with caution. Contrary to other studies that reported the correlation between postoperative visual acuity and the integrity of outer retinal layer, [9][10][11]17,33 the EZ-RPE thickness (a parameter related to the outer retinal layer status used in this study) was not a significant contributing factor. Based on the results shown in Table 1, the EZ-RPE thickness was decreased in the RRD eyes compared with fellow eyes, both in the outer-retinal-defect group and the intact-outer-retina group.…”

Section: Discussioncontrasting

confidence: 99%

“…[17][18][19][20] Menke et al 18 reported that the GC-IPL thickness decreased over time after surgery, which was supported by the study by Faude et al 19 that showed a loss of ganglion cell axons and considerable ganglion cell death, particularly in the detached retina. In contrast, Ra et al 17 reported that the thickness of the inner retinal layer did not differ significantly between RD eyes and fellow eyes after surgery. We also found that the RNFL and GC-IPL thickness in the RD eyes did not differ significantly from those in the fellow eyes after reattachment.…”

Section: Discussionmentioning

confidence: 89%

“…Several previous studies have reported the recovery of outer retinal thickness and photoreceptors over time after retinal detachment surgery in macula-off RRD. 10,11,17 Ra et al 17 used electroretinography and OCT to report a longterm increase in cone density and outer retinal layer thickness after buckling surgery for RRD. They divided EZ-RPE thickness into EZ-CIZ thickness and CIZ-RPE thickness and showed an increase in both of them 12 months postoperatively compared with 6 months postoperatively.…”

Section: Discussionmentioning

confidence: 99%

“…This suggests that the EZ-RPE thickness alone does not sufficiently reflect the integrity of the outer retinal layer. Previously, other parameters, such as the ELM-EZ thickness, 33 the ELM-RPE thickness, 33 the EZ-CIZ thickness, 17 the CIZ-RPE thickness, 17 or the inner segment/outer segment ratio, 10 have been used to reflect the status of the outer retinal layer. Our limitation was that we used only the EZ-RPE thickness as an OCT parameter to establish the outer reti-nal status.…”

Section: Discussionmentioning

confidence: 99%

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Changes in Retinal Vessel and Retinal Layer Thickness After Vitrectomy in Retinal Detachment via Swept-Source OCT Angiography

Hong

Cho

Kim

et al. 2020

Invest. Ophthalmol. Vis. Sci.

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Citation: Hong EH, Cho H, Kim DR, Kang MH, Shin YU, Seong M. Changes in retinal vessel and retinal layer thickness after vitrectomy in retinal detachment via swept-source OCT angiography. Invest Ophthalmol Vis Sci. 2020;61(2):35. https://doi.org/10.1167/iovs.61.2.35 PURPOSE.To compare postvitrectomy retinal and choroidal vessel density (VD) and retinal layer thickness between eyes with macula-off and macula-on rhegmatogenous retinal detachment (RRD) using swept-source optical coherence tomography (SS-OCT) and optical coherence tomography angiography (OCTA) and to identify OCTA factors associated with visual outcomes. METHODS.We retrospectively reviewed 31 eyes that underwent pars plana vitrectomy for primary RRD. Eyes with macula-off and macula-on RRD were compared with healthy fellow eyes. Both OCT and OCTA were performed 6 months after surgery, and the maculaoff RRD group was divided into two subgroups according to the presence of an outer retinal defect. The correlations between postoperative best-corrected visual acuity (BCVA) at 6 months and SS-OCT and OCTA measurements were analyzed. RESULTS.Twenty eyes with macula-off RRD and 11 eyes with macula-on RRD were included. In the macula-off RRD group, the central retinal thickness was significantly decreased 6 months postoperatively compared with the fellow eyes (228.9 ± 29.7 μm and 253.6 ± 27.7 μm, P = 0.009). In the outer retinal defect group, the choriocapillaris plexus (CCP) VD was significantly decreased compared with the fellow eyes (56.4% ± 4.8% and 60.2% ± 4.0%, P = 0.026). In the macula-off RRD group, the postoperative BCVA at 6 months correlated significantly with the ratio of the center CCP VD of the detached eyes to that of the fellow eyes (R 2 = 0.207, P = 0.025). CONCLUSIONS.The CCP VD could be related to the anatomical restoration of the outer retinal layer in macula-off RRD. The CCP VD as determined by OCTA could be an indicator of the visual outcome after surgery in macula-off RRD.with macula-off and macula-on RRD using swept-source OCT (SS-OCT) and OCTA and to find OCTA factors related to postoperative visual outcomes.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Changes in Retinal Vessel and Retinal Layer Thickness After Vitrectomy in Retinal Detachment via Swept-Source OCT Angiography

Hong

Cho

Kim

et al. 2020

Invest. Ophthalmol. Vis. Sci.

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“…Furthermore, the preoperative intravitreal injection of triamcinolone acetonide has been reported to suppress elevated levels of intraocular chemokines, including MCP-1, in eyes with RRD (Kunikata et al 2013). After macula-off RRD surgery, increased cone density has been confirmed with adaptive optics, suggesting postoperative regeneration of the photoreceptor outer segment (Ra et al 2017). To reinforce protection or regeneration of the photoreceptor cells, we hope to combine RRD surgery with adjunct drug administration during the perioperative period as a neuroprotective strategy in the near future.…”

Section: Neuroprotectionmentioning

confidence: 97%

Historical, Current and Future Approaches to Surgery for Rhegmatogenous Retinal Detachment

Kunikata

Abe

Nakazawa

2019

Tohoku J. Exp. Med.

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Rhegmatogenous retinal detachment (RRD) is a serious condition that can cause blindness without surgical treatment. RRD occurs when a retinal tear or hole allows fluid to accumulate below the retinal surface, causing the retina to separate from the underlying layers. RRD is difficult to treat because each case is unique, varying with the location, size, and duration of the detachment, as well as patient age. The first successful methods to reattach the retina in RRD used thermocautery to repair the detachment. Many renowned ophthalmologists continued to study RRD and developed many new surgical approaches, notably: scleral buckling (SB), in which a silicone band is placed around the eye to reduce traction on the retina caused by the vitreous humor that fills the eye; pars plana vitrectomy (PPV), which eliminates traction on the retina by removing the vitreous; and pneumatic retinopexy (PR), in which the retina is reattached by pushing it back into place with an expanding gas bubble injected into the eye. However, no consensus has been reached on which approach is ideal. Furthermore, recent surgical and non-surgical breakthroughs, such as artificial vitreous substitutes and neuroprotective drugs, must also be considered. Thus, this review provides a guide for ocular specialists and non-specialists on the historical background of RRD, summarizes the three current main techniques (SB, PR and PPV) compares these three techniques, and provides an overview of new technologies that promise to greatly improve outcomes after RRD surgery.

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Functional recovery after macula involving retinal detachment and its correlation with preoperative biomarkers in optical coherence tomography

Klaas

Rechl

Feucht

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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To introduce an ETDRS grid-based classification for macula involving retinal detachment (MIRD) with or without center (foveal) involvement and to identify biomarkers in preoperative optical coherence tomography (OCT) associated with a favorable postoperative functional outcome in eyes with center involving retinal detachment (CIRD). One hundred and two eyes of 102 consecutive patients (f/m: 35/67) with primary rhegmatogenous retinal detachment, preoperative evidence of MIRD (perifoveal involvement of ≤ 6.0 mm), and successful retinal surgery were included in this retrospective cohort study. Eyes were assigned to 5 grades of MIRD (G1–G5), based on the extent of detachment in the ETDRS grid. Eyes with a detached foveal status (CIRD) were assigned to G4 or G5. In CIRD, the following OCT biomarkers were quantified and correlated with mean BCVA (logMAR) at 3 months postsurgery, using univariate and multivariable regression models: grade of detachment, extent of intraretinal edema, height of foveal detachment, subretinal folds, and epiretinal membrane. Forty-one of 102 eyes (40.2%) presented with an attached foveal status, defined as either outer (G1: 11.8%) or inner (G2: 18.6%) macular involvement or fovea-threatening MIRD (G3: 9.8%). Sixty-one eyes (59.8%) showed CIRD (G4 or G5). Eyes with CIRD had significantly worse postoperative BCVA than eyes without foveal involvement (0.355 logMAR vs. 0.138 logMAR, p<0.001). If CIRD was limited to three outer ETDRS quadrants (G4), mean BCVA was better compared to CIRD involving all four ETDRS quadrants (G5) (0.254 logMAR vs. 0.522 logMAR, p<0.001). Reading ability (BCVA ≤ 0.4 logMAR) was restored in 97.6% of eyes with G1–G3 compared to 86.9% of eyes with G4 (p=0.072) and 52.4% of eyes with G5 (p<0.001). In multivariable regression analysis of eyes with CIRD, a lower grade of detachment (G4 vs. G5: p<0.05) and lower extent of cystoid edema (focal/none vs. wide: p<0.001) were both associated with better postoperative function. The functional outcome after MIRD may be worse in the presence of foveal involvement (CIRD), but a lower grade of detachment and the absence of intraretinal edema can predict a good recovery in spite of CIRD.

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Regeneration of Photoreceptor Outer Segments After Scleral Buckling Surgery for Rhegmatogenous Retinal Detachment

Cited by 28 publications

References 45 publications

Changes in Retinal Vessel and Retinal Layer Thickness After Vitrectomy in Retinal Detachment via Swept-Source OCT Angiography

Changes in Retinal Vessel and Retinal Layer Thickness After Vitrectomy in Retinal Detachment via Swept-Source OCT Angiography

Historical, Current and Future Approaches to Surgery for Rhegmatogenous Retinal Detachment

Functional recovery after macula involving retinal detachment and its correlation with preoperative biomarkers in optical coherence tomography

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