High-speed, high-resolution spectral optical coherence tomography in patients after vitrectomy with internal limiting membrane peeling for proliferative vitreoretinopathy retinal detachment

Abstract

Purpose: The purpose of this study was to present the retinal morphology after silicone oil removal in patients after vitrectomy with internal limiting membrane peeling and silicone oil tamponade for proliferative vitreoretinopathy retinal detachment.

Methods: Nineteen patients after vitrectomy or retinotomy with internal limiting membrane peeling for proliferative vitreoretinopathy retinal detachment were included in this study. All patients were interviewed, and an ophthalmologic examination was performed pre- and postoperatively. Fifteen months after silicone oil removal, all patients were examined with spectral optical coherence tomography Copernicus.

Results: Visual acuities determined at the final follow-up visit were from light perception to 20/40 (mean, 0.11 +/- 0.14). Photoreceptor damage was present in 19 eyes (100%), i.e., in all cases. In seven eyes, the defects were in the well-visible, normal-thickness photo-receptor layer. In the remaining 12 eyes, defects were found in the thin, atrophic photo-receptor layer. Eyes with a well-visible photoreceptor layer had better visual acuity after surgery (P = 0.015; t-test). Cystoid macular edema developed in 9 eyes (47.3%). Retinal nerve fiber layer defects were found in all 19 eyes (100%). Subretinal fluid was present in 1 eye (5.2%). No cases of macular pucker were observed during follow-up.

Conclusion: Spectral optical coherence tomography Copernicus allows detailed imaging of retinal microstructure and helps us understand why patients have lowered visual acuity after successful retinal detachment surgeries. It is suspected that the absence of macular pucker may be caused by systematic peeling of the internal limiting membrane during vitrectomy.