Morphologic Features of Regulated vs. Dysregulated Rhegmatogenous Retinal Detachment Using Swept-Source Optical Coherence Tomography - 26/11/24
Highlights |
• | Morphologic features of regulated and dysregulated retinal detachment (RD) differ. |
• | Dysregulated RRDs are more likely to have outer retinal corrugations. |
• | Regulated RRD occurs in young patients with retinal holes and attached hyaloid. |
• | Dysregulated RRD occurs in patients with vitreous separation and horseshoe tears. |
• | Understanding of the morphological differences in RRD has clinical implications. |
Résumé |
Objective |
To describe varying morphological features of patients with RRD based on the extent of regulation of the subretinal space by the retinal pigment epithelium (RPE) pump using swept-source optical coherence tomography (SS-OCT).
Design |
Prospective clinical cohort study.
Methods |
Setting: St. Michael's Hospital, Toronto, Canada, from August 2020-August 2023.
Participants: 120 consecutive eyes with primary RRD.
Cohorts: Subclinical, non-progressive, localized RRD defined as regulated vs. acute, progressive, and extensive defined as dysregulated, assessed with SS-OCT.
Main Outcome: Morphological features of regulated vs. dysregulated RRDs with SS-OCT.
Results |
19.2% (23/120) of RRDs were classified as regulated and 80.8% (97/120) were dysregulated. The mean age of patients with regulated RRDs was 37.1 years (±13.7 SD) vs. 62.6 years (±11.6SD) for patients with dysregulated RRDs (P < .001). The presence of outer retinal corrugations (ORCs) on OCT was observed in 4.3% (1/23) of regulated vs. 81.4% (79/97) of dysregulated RRDs (P < .001). CME was found in 41.6% (5/12) of regulated RRDs compared to 87.3% (83/95) of dysregulated RRDs (P < .001). ORC presence was an independent predictor of having a dysregulated RRD (P = .02, β = 6.6, 95% CI [1.3-33.2]) when controlling for age, sex, baseline VA, lens status, and RD extent. Among patients with regulated RRDs, 25.0% (3/12) were in Stage 2, 0% (0/16) in Stage 3A, 8.3% (1/12) in Stage 3B, 0% (0/16) in Stage 4, and 66.7% (8/12) in Stage 5. In patients with dysregulated RRDs, 14.7% (14/95) were in Stage 2, 15.7% (15/95) were in Stage 3A, 37.9% (36/95) in Stage 3B, 22.1% (21/95) in Stage 4, and 9.5% (9/95) in Stage 5 (P < .001).
Conclusions |
There are significant morphologic differences between regulated and dysregulated RRDs using SS-OCT. ORCs are present in almost all dysregulated cases but in a minority of regulated cases and they are an independent predictor of RPE-photoreceptor regulation status. Demographic and clinical features differentiate regulated and dysregulated RRD and understanding these differences has significant implications for optimal management and postoperative outcomes.
Le texte complet de cet article est disponible en PDF.Plan
Vol 268
P. 19-28 - décembre 2024 Retour au numéro
Article précédent
- Systemic Arterial Stiffness and Choroidal Microvascular Insufficiency on the Structural Progression of Normal Tension Glaucoma
- JIHEI SARA LEE, HYOUNG WON BAE, CHAN YUN KIM, SANG YEOP LEE
- Drug Exposure As a Predictor in Diabetic Retinopathy Risk Prediction Models—A Systematic Review and Meta-Analysis
- Maria Anna Bantounou, Tulika A.K. Nahar, Josip Plascevic, Niraj Kumar, Mintu Nath, Phyo K Myint, Sam Philip
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?