Ultra-wide-field autofluorescence imaging in non-traumatic rhegmatogenous retinal detachment

Abstract

Purpose Rhegmatogenous retinal detachment (RRD) affects the function of the retina before and after surgical repair. We investigated ultra-wide-field autofluorescence (UAF) abnormalities in patients with acute RRD to improve our understanding of the functional changes in the retina before and after surgery. Methods In this retrospective study, we present the UAF imaging findings of 16 patients with acute, non-traumatic RRD. Imaging was obtained with the Optos 200 Tx (Optos) in 14 eyes preoperatively and in 12 eyes postoperatively. Twelve eyes had RRDs that involved the macula (group A), whereas four eyes had macula-sparing RRDs (group B). Results All patients (100%) with bullous retinal detachments demonstrated hypofluorescence over the area of retinal detachment. A hyperfluorescent leading edge (HLE) to the retinal detachment was observed preoperatively in 100% of eyes in group A and 75% of eyes in group B. Preoperative UAF through the fovea of group A eyes was normal (30%), hypofluorescent (50%) or hyperfluorescent (20%). In all patients with a HLE preoperatively, the HLE resolved by the 1-month postoperative visit. A residual line of demarcation remained in 8 of the 12 eyes (67%). In group A eyes, postoperative granular autofluorescent changes were present in four of the nine (44%) eyes, and were associated with worse preoperative (P ¼ 0.04) and postoperative (P ¼ 0.09) visual acuity. Conclusion UAF imaging reveals abnormalities in RRDs that allow excellent demarcation of the extent of the retinal detachment and assist in preoperative characterization of the detachment and postoperative counselling.

Ultra-Widefield Retina Imaging: Principles of Technology and Clinical Applications

“…Compared to indirect ophthalmoscopy, UWF imaging can, in some cases, provide a more precise documentation of the extent of the detachment [38]. The UWF FAF provides prognostic information and a means for examining the postoperative functional status of the previously detached retina [37,39]. Witmer et al [37] reported that patients with macula-involving detachments who showed persistent postoperative granular autofluorescent changes had significantly worse preoperative visual acuity and showed a trend toward worse postoperative visual prognosis.…”

“…The UWF FAF provides prognostic information and a means for examining the postoperative functional status of the previously detached retina [37,39]. Witmer et al [37] reported that patients with macula-involving detachments who showed persistent postoperative granular autofluorescent changes had significantly worse preoperative visual acuity and showed a trend toward worse postoperative visual prognosis. Labriola et al [40] reported on a case in which UWF and UWF FA were helpful in documenting neovascularization and macrocyst formation associated with chronic retinal detachment (Fig.…”

“…UWF pseudocolor and autof luorescence imaging show abnormalities in the rhegmatogenous retinal detachment allowing excellent localization of causative retinal breaks and demarcation of the extent of the retinal detachment [37]. Compared to indirect ophthalmoscopy, UWF imaging can, in some cases, provide a more precise documentation of the extent of the detachment [38].…”

Advances in Imaging in Age-Related Macular Degeneration

“…For example, the use of filters allows ultrawidefield autofluorescence and angiographic imaging [48,50]. Ultrawidefield autofluorescence imaging may be of particular use for detection of degenerative changes of the peripheral retina in patients with AMD [51].…”

Ultra-Widefield Imaging for the Management of Pediatric Retinal Diseases

“…8,9 This imaging modality, known as "ultra-widefield," has been used in the adult patient population to evaluate and manage various retinal diseases, including diabetic retinopathy, choroidal lesions, uveitis, retinal vascular occlusion, retinal detachment, and sickle cell retinopathy. 6,7,[10][11][12][13][14][15][16][17][18][19][20][21] However, the feasibility and utility of this imaging modality have not been well characterized in the pediatric patient population. In this case series, we demonstrate the utility of using ultra-widefield digital fundus photography and ultra-widefield fluorescein angiography (UWFA) in the pediatric patient population to evaluate peripheral retinal pathology and to assist in the management and treatment of Coats' disease and FEVR.…”