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

Lookup NU author(s): Roxane Hillier


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© 2021 Elsevier Inc. 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.

Publication metadata

Author(s): Figueiredo N, Sarraf D, Gunnemann F, Sadda SR, Bansal A, Berger AR, Wong DT, Kohly RP, Kertes PJ, Hillier RJ, Muni RH

Publication type: Article

Publication status: Published

Journal: American Journal of Ophthalmology

Year: 2022

Volume: 236

Pages: 212-220

Print publication date: 01/04/2022

Online publication date: 22/10/2021

Acceptance date: 12/10/2021

ISSN (print): 0002-9394

ISSN (electronic): 1879-1891

Publisher: Elsevier Inc.


DOI: 10.1016/j.ajo.2021.10.012

PubMed id: 34695399


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