Spectral domain-optical coherence tomography study of retinas with a normal foveal contour and thickness after retinal detachment surgery.
OBJECTIVE
The purpose was to study the disruption of the inner segment (IS) and outer segment (OS) junction associated with suboptimal visual outcome after successful retinal detachment surgery with an otherwise normal foveal contour and thickness.


METHODS
A comparative study of 2 groups, i.e., group I-suboptimal visual outcome (visual acuity <20/40) and group II-optimal visual outcome (visual acuity> or =20/40), with 7 eyes of 7 patients in each group rhegmatogenous retinal detachment surgery with an otherwise normal foveal contour and thickness on spectral domain-optical coherence tomography was evaluated for disruption of the IS and OS junction at 6 weeks using the crosshair protocol through the fovea. A 5 x 5-mm grid raster protocol (E MM5)imaged 256 squares of retina and the number of squares with IS and OS junction disruption was correlated with best-corrected visual acuity.


RESULTS
Disruption of the IS and OS junction was seen in all 7 eyes of group I (100%)compared with 2 eyes in group II (28%), which was an obvious statistical difference (P =0.021). Also, a statistically significant correlation existed (r = 0.84, P < 0.05) when best-corrected visual acuity was plotted against the number of squares with IS and OS disruption. There was a statistically insignificant (P = 0.09) trend noted toward greater IS and OS junction disruption in eyes with prior macula off rhegmatogenous retinal detachments on univariate analysis.


CONCLUSIONS
Disruption of the IS and OS junction could be a surrogate measure of the structural and functional health of the photoreceptors and can explain poor visual outcome in postsuccessful retinal detachment surgery with an otherwise normal foveal contour and thickness.
Sheth
Saumil
S
Department of Vitreo Retina, Aditya Jyot Eye Hospital, Mumbai, India. saumil_sheth@hotmail.com
Dabir
Supriya
S
Natarajan
Sundaram
S
Mhatre
Amol
A
Labauri
Nickolz
N
D000328:Adult; D003430:Cross-Sectional Studies; D003452:Cryosurgery; D005260:Female; D005584:Fovea Centralis; D006801:Humans; D008297:Male; D008875:Middle Aged; D012163:Retinal Detachment / Q000503:physiopathology / Q000601:surgery*; D055211:Retinal Photoreceptor Cell Inner Segment / Q000473:pathology*; D055214:Retinal Photoreceptor Cell Outer Segment / Q000473:pathology*; D012591:Scleral Buckling; D012827:Silicone Oils / Q000008:administration & dosage; D041623:Tomography, Optical Coherence; D014786:Vision Disorders / Q000503:physiopathology*; D014792:Visual Acuity / Q000502:physiology*; D014821:Vitrectomy
D012827:Silicone Oils