Value of optical coherence tomography in the detection of macular pathology before the removal of silicone oil

Abstract

PurposeTo assess the pathological macular changes with optical coherence tomography (OCT) before the removal of silicone oil (SiO) in eyes that had undergone pars plana vitrectomy for complicated forms of retinal detachment (RD).Patients and methodsSubjects included 48 patients (51 eyes) with complicated RD including proliferative vitreoretinopathy, proliferative diabetic retinopathy, recurrent RD, penetrating trauma, uveitis, giant retinal tears, and macular holes. All the eyes had undergone SiO injection. Furthermore, all eyes had been planned for the removal of SiO 6–12 months after the primary surgery. Finally, all eyes had a fundus examination and OCT examination before the silicone oil removal.ResultsOCT findings indicated epiretinal membrane in 41% of the eyes, macular edema in 17%, macular detachment in 13.5%, macular thinning in 13.5%, macular holes in 10%, and subretinal membranes in 2%. Preoperative OCT was normal in only 12% of the eyes, while a clinical fundus examination was normal in 43% (P<0.001). Eyes with normal OCT had significantly better mean logMAR (0.35) than eyes with pathological changes detected through OCT (1.28; P<0.001). Surgical modifications were made during the removal of SiO in 74.5% of the eyes.ConclusionOCT detected significantly more pathological changes than a clinical fundus examination. This had an impact on both surgical step modification during the removal of SiO and predictability of visual outcome after the removal of SiO.

Incidence and Risk Factors of Cystoid Macular Edema after Vitrectomy with Silicone Oil Tamponade for Retinal Detachment

“…In the present study, the incidence of CME after vitrectomy with SO tamponade was found to be 36.2%, which is higher than that reported by previous studies (13.6% to 27.5%) [ 11 12 13 14 ]. Upon comparative evaluation of preoperative and postoperative SD-OCT images of 46 eyes that received vitrectomy with SO tamponade, Bae et al [ 12 ] reported CME in 9 (19.6%) eyes before SO removal.…”

“…Kiss et al [ 13 ] reported the development of CME after SO tamponade only in eyes with RD caused by PVR (7 / 39 eyes, 17.1%). Rashad et al [ 11 ] reported a 27.5% incidence of CME (14 of 51 eyes) using SD-OCT–based diagnosis. Karahan et al [ 14 ] reported a 13.6% incidence of CME (3 of 22 eyes) among patients with rhegmatogenous RD who received SO tamponade.…”

“…Cystoid macular edema (CME) is defined as the localized expansion of the extracellular space in the macular area of the retina and is characterized by a radial cystic pattern in the perifoveal region [ 10 ]. Spectral-domain optical coherence tomography (SD-OCT) can provide high-resolution in vivo cross-sectional images of the retina even in the presence of intraocular SO [ 11 ] and can reveal histological changes in the retina. This imaging modality has been used recently to establish CME as one of the retinal complications of SO tamponade.…”

Macular thickness in healthy Saudi adults

“… 1 Optical coherence tomography (OCT) is a non-invasive technology that provides in vivo high-resolution measurements of the macular thickness that enables clinicians to detect and monitor subtle changes in macular thickness. 2 - 7 Normative macular thickness was obtained by several studies using OCT. 8 , 9 Spectral domain OCT (SD-OCT) systems are faster and more sensitive than time-domain OCT (TD-OCT) systems that provide an improved resolution, more accurate segmentation, and data points. 10 - 12 One important feature of SD-OCT raster scans is its ability to reconstruct a fundus-like image as soon as the scan is acquired.…”

Macular edema in siliconized eyes

“…We read with great interest the article titled “Value of optical coherence tomography in the detection of macular pathology before the removal of silicone oil” by Rashad et al 1 The authors have evaluated the optical coherence tomography (OCT) findings before the removal of silicone oil (SiO). We congratulate the authors for this well-organized study and would like to contribute to their findings.…”