Functional recovery after macula involving retinal detachment and its correlation with preoperative biomarkers in optical coherence tomography.

Klaas, Julian E; Rechl, Philip; Feucht, Nikolaus; Siedlecki, Jakob; Friedrich, Julia; Lohmann, Chris P; Maier, Mathias

doi:10.1007/s00417-021-05113-3

2021

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Titel:: Functional recovery after macula involving retinal detachment and its correlation with preoperative biomarkers in optical coherence tomography.
Dokumenttyp:: Journal Article
Autor(en):: Klaas, Julian E; Rechl, Philip; Feucht, Nikolaus; Siedlecki, Jakob; Friedrich, Julia; Lohmann, Chris P; Maier, Mathias
Abstract:: To introduce an ETDRS grid-based classification for macula involving retinal detachment (MIRD) with or without center (foveal) involvement and to identify biomarkers in preoperative optical coherence tomography (OCT) associated with a favorable postoperative functional outcome in eyes with center involving retinal detachment (CIRD). One hundred and two eyes of 102 consecutive patients (f/m: 35/67) with primary rhegmatogenous retinal detachment, preoperative evidence of MIRD (perifoveal involvement of ≤ 6.0 mm), and successful retinal surgery were included in this retrospective cohort study. Eyes were assigned to 5 grades of MIRD (G1-G5), based on the extent of detachment in the ETDRS grid. Eyes with a detached foveal status (CIRD) were assigned to G4 or G5. In CIRD, the following OCT biomarkers were quantified and correlated with mean BCVA (logMAR) at 3 months postsurgery, using univariate and multivariable regression models: grade of detachment, extent of intraretinal edema, height of foveal detachment, subretinal folds, and epiretinal membrane. Forty-one of 102 eyes (40.2%) presented with an attached foveal status, defined as either outer (G1: 11.8%) or inner (G2: 18.6%) macular involvement or fovea-threatening MIRD (G3: 9.8%). Sixty-one eyes (59.8%) showed CIRD (G4 or G5). Eyes with CIRD had significantly worse postoperative BCVA than eyes without foveal involvement (0.355 logMAR vs. 0.138 logMAR, p<0.001). If CIRD was limited to three outer ETDRS quadrants (G4), mean BCVA was better compared to CIRD involving all four ETDRS quadrants (G5) (0.254 logMAR vs. 0.522 logMAR, p<0.001). Reading ability (BCVA ≤ 0.4 logMAR) was restored in 97.6% of eyes with G1-G3 compared to 86.9% of eyes with G4 (p=0.072) and 52.4% of eyes with G5 (p<0.001). In multivariable regression analysis of eyes with CIRD, a lower grade of detachment (G4 vs. G5: p<0.05) and lower extent of cystoid edema (focal/none vs. wide: p<0.001) were both associated with better postoperative function. The functional outcome after MIRD may be worse in the presence of foveal involvement (CIRD), but a lower grade of detachment and the absence of intraretinal edema can predict a good recovery in spite of CIRD.
Zeitschriftentitel:: Graefes Arch Clin Exp Ophthalmol
Jahr:: 2021
Band / Volume:: 259
Heft / Issue:: 9
Seitenangaben Beitrag:: 2521-2531
Volltext / DOI:: doi:10.1007/s00417-021-05113-3
PubMed:: http://view.ncbi.nlm.nih.gov/pubmed/33675394
Print-ISSN:: 0721-832X
TUM Einrichtung:: 588; Klinik und Poliklinik für Augenheilkunde
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Augenheilkunde (Prof. Maier komm.)2021