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[Intraoperative OCT in retinal detachment with macular involvement].

V Degenhardt1, R Khoramnia1, J Storr2

  • 1Klink und Poliklinik für Augenheilkunde, Universität Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.

Der Ophthalmologe : Zeitschrift Der Deutschen Ophthalmologischen Gesellschaft
|October 7, 2020
PubMed
Summary

Intraoperative optical coherence tomography (iOCT) provides real-time retinal insights during detachment surgery. It reveals subretinal fluid and outer retinal layer changes, offering data sometimes unseen by the naked eye.

Keywords:
Imaging of endotamponadesMacular surgeryRetinal detachmentRetinal folds

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Area of Science:

  • Ophthalmology
  • Surgical Innovation
  • Medical Imaging

Background:

  • Intraoperative optical coherence tomography (iOCT) is a novel technology for visualizing retinal structures during surgery.
  • It integrates with the operating microscope to enhance surgical visualization.

Purpose of the Study:

  • To analyze retinal behavior and morphological changes during surgery for retinal detachment with macular involvement.
  • To evaluate the utility of iOCT in visualizing these changes.

Main Methods:

  • Retrospective analysis of 41 eyes with macula-off retinal detachment.
  • Pars plana vitrectomy (PPV) performed with iOCT guidance.
  • Qualitative analysis of intraoperative retinal morphology at key surgical moments.

Main Results:

  • iOCT successfully visualized macular detachment in 63% of cases; others exceeded scan depth.
  • Subretinal fluid detected in 53.7% of eyes; outer retinal layers showed wave-like configuration in 22%.
  • Persistent subretinal fluid found in 61% of eyes post-tamponade, often undetectable by naked eye.

Conclusions:

  • iOCT rarely alters surgical plans but provides crucial real-time fluid and structural data.
  • The clinical significance of persistent subretinal fluid and outer retinal folds post-surgery requires further investigation.
  • These findings may serve as potential prognostic indicators for surgical outcomes.