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Longitudinal Assessment of Ellipsoid Zone Recovery Using En Face Optical Coherence Tomography After Retinal
Natalia Figueiredo1, David Sarraf2, Frederic Gunnemann3
1Department of Ophthalmology and Vision Sciences (N.F., A.B., A.R.B., D.T.W., R.P.K., P.J.K., R.H.M.), University of Toronto, Toronto, Ontario, Canada; Department of Ophthalmology (N.F., A.B., A.R.B., D.T.W., R.H.M.), St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
En face optical coherence tomography (OCT) shows ellipsoid zone (EZ) recovery after rhegmatogenous retinal detachment (RRD) repair. This EZ healing correlates with improved visual acuity, especially in patients with shorter macula-off durations.
Area of Science:
- Ophthalmology
- Retinal Imaging
- Vision Science
Background:
- Suboptimal visual outcomes after rhegmatogenous retinal detachment (RRD) repair can stem from photoreceptor damage, specifically to the ellipsoid zone (EZ).
- Standard cross-sectional optical coherence tomography (OCT) may not fully reveal these EZ alterations.
- En face OCT offers a potential method to assess EZ integrity post-RRD repair.
Purpose of the Study:
- To evaluate ellipsoid zone (EZ) recovery using en face OCT after rhegmatogenous retinal detachment (RRD) repair.
- To determine the association between EZ recovery and visual acuity outcomes.
Main Methods:
- A post hoc analysis of a randomized controlled trial involving patients with macula-off RRD.
- En face OCT imaging of the EZ slab was performed at multiple postoperative time points (3 months to 4 years).
- Quantification of EZ hyporeflective areas (indicating abnormalities) and correlation with Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity scores.
Main Results:
- The mean area of EZ hyporeflectivity significantly decreased from 3 to 24 months post-RRD repair (P < .0001) and continued to reduce up to 4 years.
- A significant association was found between the change in EZ hyporeflective area and the change in ETDRS visual acuity letter score from 3 to 24 months (R² = 14.8%).
- Longer duration of macula-off RRD was associated with a greater change in EZ hyporeflectivity (R² = 13.7%).
Conclusions:
- En face OCT serves as a valuable biomarker for visualizing and quantifying EZ recovery post-RRD repair.
- EZ recovery, as assessed by en face OCT, is significantly associated with visual acuity recovery.
- Delayed EZ recovery is observed in patients with longer durations of macula-off RRD, highlighting the importance of timely intervention.
