title: [Macula analysis by spectral domain OCT in rhegmatogenous retinal detachment surgery].
abstract: BACKGROUND
  Despite surgical reattachment of retinal layers, postoperative functional outcomes after rhegmatogenous retinal detachment (RRD) may be limited. This can be explained by microstructural changes in the macula inherent to the pathology itself as well as the surgery.
  
  
  OBJECTIVE
  To evaluate the various changes in the macula by OCT pre- and postoperatively, and correlate them with functional and clinical outcomes in patients with RRD. To establish pre- and postoperative prognostic factors.
  
  
  METHODS
  This was a prospective study of 50 eyes of 50 patients operated for RDD. Each patient underwent a complete clinical examination and macular OCT using the Heidelberg Spectralis; preoperatively and then successively at 7 days, 1 month, 3 months and 6 months after RRD surgery.
  
  
  RESULTS
  Preoperative tomographic results revealed an average height of submacular fluid of 742 ± 345 μm. Ninety-six percent of patients exhibited thickening of photoreceptor outer segments (PROS), 62% an outer layer undulation, 60% cystic cavities in the outer and/or inner nuclear layers (ONL, INL), 36% disruptions of the external limiting membrane (ELM) and 64% disruption of the IS/OS junction. Postoperatively, 24% of patients had persistent submacular fluid. The average thickness of the central fovea, the ONL, the IS/OS junction and the PROS were 172 ± 51.3 μm, 88.4 ± 30.9 μm, 11.36 ± 5.4 μm and 19.54 ± 13.1 μm respectively. Postoperative disruptions of the ELM, the IS/OS junction and Verhoeff's membrane (VM) were present in 24%, 60% and 82% of patients respectively. The preoperative tomographic risk factors for poor visual outcome were: submacular fluid height > 800 μm (P<0.001), disruptions of the MLE and/or IS/OS junction (P<0.001), as well as cystic cavities in the ENL and/or INL (P=0.002). Postoperative risk factors were: thinning of the fovea (≤ 250 μm), central fovea (≤ 160 μm), ONL (≤ 90 μm), IS/OS junction (≤ 10 μm) and PROS (≤ 18 μm) layers (P<0.001), as well as a discontinuous or absent appearance of the ELM (P<0.001), IS/OS junction (P<0.001) and VM (P=0.006).
  
  
  CONCLUSIONS
  Spectral domain OCT allows detection of specific microscopic, quasi-histologic macular changes in rhegmatogenous retinal detachment. These anomalies could be predictive of final postoperative visual outcome.
authors: Institut Hédi-Raies d'ophtalmologie de Tunis, faculté de médecine de Tunis, boulevard du 9-Avril-1938-Bab-Saâdoun, 1007 Tunis, Tunisie.
authors: I
authors: I
authors: Zghal
authors: Institut Hédi-Raies d'ophtalmologie de Tunis, faculté de médecine de Tunis, boulevard du 9-Avril-1938-Bab-Saâdoun, 1007 Tunis, Tunisie. Electronic address: hsouna_zgolli@yahoo.com.
authors: H
authors: H
authors: Zgolli
authors: Institut Hédi-Raies d'ophtalmologie de Tunis, faculté de médecine de Tunis, boulevard du 9-Avril-1938-Bab-Saâdoun, 1007 Tunis, Tunisie.
authors: O
authors: O
authors: Fekih
authors: Institut Hédi-Raies d'ophtalmologie de Tunis, faculté de médecine de Tunis, boulevard du 9-Avril-1938-Bab-Saâdoun, 1007 Tunis, Tunisie.
authors: A
authors: A
authors: Chebbi
authors: Institut Hédi-Raies d'ophtalmologie de Tunis, faculté de médecine de Tunis, boulevard du 9-Avril-1938-Bab-Saâdoun, 1007 Tunis, Tunisie.
authors: H
authors: H
authors: Bouguila
authors: Institut Hédi-Raies d'ophtalmologie de Tunis, faculté de médecine de Tunis, boulevard du 9-Avril-1938-Bab-Saâdoun, 1007 Tunis, Tunisie.
authors: L
authors: L
authors: Nacef
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005584:Fovea Centralis / Q000473:pathology; D006801:Humans; D007223:Infant; D008266:Macula Lutea; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D011379:Prognosis; D011446:Prospective Studies; D012163:Retinal Detachment / Q000175:diagnosis* / Q000601:surgery*; D012164:Retinal Diseases / Q000175:diagnosis*; D012307:Risk Factors; D013223:Statistics as Topic; D041623:Tomography, Optical Coherence / Q000379:methods*; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology; D055815:Young Adult
keywords: Décollement de rétine rhegmatogène; Macula; Optical coherence tomography; Rhegmatogenous retinal detachment; Tomographie par cohérence optique