Longitudinal Assessment of Ellipsoid Zone Recovery Using En Face Optical Coherence Tomography After Retinal Detachment Repair,American Journal of Ophthalmology

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Longitudinal Assessment of Ellipsoid Zone Recovery Using En Face Optical Coherence Tomography After Retinal Detachment Repair
American Journal of Ophthalmology ( IF 4.2 ) Pub Date : 2021-10-22 , DOI: 10.1016/j.ajo.2021.10.012
Natalia Figueiredo ₁ , David Sarraf ₂ , Frederic Gunnemann ₃ , Srinivas R Sadda ₃ , Aditya Bansal ₁ , Alan R Berger ₁ , David T Wong ₁ , Radha P Kohly ₄ , Peter J Kertes ₄ , Roxane J Hillier ₅ , Rajeev H Muni ₆

Affiliation

Department of Ophthalmology and Vision Sciences (N.F., A.B., A.R.B., D.T.W., R.P.K., P.J.K., R.H.M.), University of Toronto, Toronto, Ontario, Canada; Department of Ophthalmology (N.F., A.B., A.R.B., D.T.W., R.H.M.), St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
Department of Ophthalmology (D.S., F.G., S.R.S.), David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA.
Department of Ophthalmology (D.S., F.G., S.R.S.), David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA; Doheny Image Reading Center (F.G., S.R.S.), Doheny Eye Institute, Los Angeles, California, USA.
Department of Ophthalmology and Vision Sciences (N.F., A.B., A.R.B., D.T.W., R.P.K., P.J.K., R.H.M.), University of Toronto, Toronto, Ontario, Canada; Kensington Vision and Research Centre (R.P.K., P.J.K., R.H.M.), University of Toronto, Toronto, Ontario, Canada; The John and Liz Tory Eye Centre (R.P.K., P.J.K.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle upon Thyme, United Kingdom; Institute of Translational and Clinical Research (R.J.H.), Newcastle University, Newcastle upon Thyme, United Kingdom.
Department of Ophthalmology and Vision Sciences (N.F., A.B., A.R.B., D.T.W., R.P.K., P.J.K., R.H.M.), University of Toronto, Toronto, Ontario, Canada; Department of Ophthalmology (N.F., A.B., A.R.B., D.T.W., R.H.M.), St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada; Kensington Vision and Research Centre (R.P.K., P.J.K., R.H.M.), University of Toronto, Toronto, Ontario, Canada; Keenan Research Centre for Biomedical Science (R.J.H., R.H.M.)/Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada.

Purpose

Suboptimal functional outcomes after rhegmatogenous retinal detachment (RRD) repair may be related to photoreceptor abnormalities, including alterations of the ellipsoid zone (EZ) that may not be apparent on cross-sectional optical coherence tomography (OCT). This study assessed EZ recovery using en face OCT after RRD repair and its association with visual acuity.

Design

Post hoc analysis of a randomized controlled trial.

Methods

Patients with macula-off RRD were monitored at 3, 6, 12, and 24 months postoperatively and annually thereafter. En face OCT of the EZ slab were analyzed. Hyporeflective areas were colocalized with EZ abnormalities on cross-sectional OCT B-scans and measured by 2 masked graders. Primary outcome was change in area of EZ hyporeflectivity from 3 to 24 months, and its association with Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity recovery was also assessed.

Results

In total, 271 images of 61 patients were assessed. Mean area of hyporeflectivity significantly decreased from 3 to 24 months (−2.98 mm²; 95% CI, 1.82-4.13 mm²; P < .0001), with further reductions up to 4 years. Linear regression revealed an association between change in hyporeflective area and change in the ETDRS letter score from 3 to 24 months (β = −0.31, P = .009, R² = 14.8%) and between duration of macula-off and change in hyporeflective area from 3 to 24 months (β = −0.37, P = .018, R² = 13.7%).

Conclusions

En face OCT provides a novel biomarker for visualizing and quantifying EZ recovery after RRD repair that is associated with ETDRS visual acuity recovery. A steady decline in the area of EZ hyporeflectivity was observed over many years with delayed recovery in patients with longer duration of macula-off.

中文翻译：

视网膜脱离修复后使用 En Face 光学相干断层扫描对椭球区恢复的纵向评估

目的

孔源性视网膜脱离 (RRD) 修复后的次优功能结果可能与光感受器异常有关，包括在横截面光学相干断层扫描 (OCT) 上可能不明显的椭圆体区 (EZ) 改变。本研究在 RRD 修复后使用正面 OCT 评估 EZ 恢复及其与视力的关系。

设计

随机对照试验的事后分析。

方法

黄斑脱落 RRD 患者在术后 3、6、12 和 24 个月以及之后每年进行监测。分析了 EZ 板的正面 OCT。在横断面 OCT B 扫描中，低反射区域与 EZ 异常共定位，并由 2 名蒙面分级员测量。主要结果是 3 至 24 个月内 EZ 低反射率区域的变化，还评估了其与早期治疗糖尿病视网膜病变研究 (ETDRS) 视力恢复的关系。

结果

总共评估了 61 名患者的 271 张图像。从 3 个月到 24 个月，低反射率的平均面积显着下降（-2.98 mm ²；95% CI，1.82-4.13 mm ²；P < .0001），进一步减少长达 4 年。线性回归显示低反射区域的变化与 3 至 24 个月的 ETDRS 字母评分变化之间存在关联（β = -0.31，P = .009，R ² = 14.8%），以及黄斑关闭持续时间与低反射变化之间的关联。 3 到 24 个月的区域（β = -0.37，P = .018，R ² = 13.7%）。