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Optical Coherence Tomography Features in Fovea-Off Exudative vs Rhegmatogenous Retinal Detachment.

Paola L Oquendo1, Guneet S Sodhi2, Sumana C Naidu3

  • 1From the Department of Ophthalmology and Vision Sciences, University of Toronto (P.L.O., I.M.M., A.P., S.D., W.W.L., P.G.C., H.H., A.B., R.H.M.), Toronto, Ontario, Canada.

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|July 21, 2024
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Outer retinal corrugations (ORCs) on optical coherence tomography (OCT) are highly specific for rhegmatogenous retinal detachment (RRD) and absent in exudative retinal detachment (ERD), aiding differential diagnosis.

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Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Retinal Diseases

Background:

  • Differentiating exudative retinal detachment (ERD) from rhegmatogenous retinal detachment (RRD) is crucial for appropriate management.
  • Optical coherence tomography (OCT) provides detailed cross-sectional imaging of the retina, aiding in the diagnosis of various retinal pathologies.

Purpose of the Study:

  • To delineate the specific optical coherence tomography (OCT) features distinguishing fovea-off exudative retinal detachment (ERD) from rhegmatogenous retinal detachment (RRD).
  • To investigate the diagnostic utility of outer retinal corrugations (ORCs) in differentiating ERD from RRD.

Main Methods:

  • A multicenter, retrospective cross-sectional study included 161 eyes (51 ERD, 110 RRD) diagnosed between 2016 and 2021.
  • High-resolution spectral-domain OCT (SD-OCT) imaging was analyzed for morphological features, focusing on the macula and outer retina.
  • Exclusion criteria included specific conditions like choroidal neovascularization, optic nerve pits, and poor image quality.

Main Results:

  • Eyes with ERD showed a higher prevalence of subretinal fluid with hyperreflective material/dots, inner retinal undulations, and retinal pigment epithelium undulations compared to RRD.
  • Rhegmatogenous retinal detachment (RRD) was significantly associated with outer retinal corrugations (ORCs) (80% vs 0%, P < .001), intraretinal fluid, and ellipsoid zone thickening.
  • Outer retinal corrugations (ORCs) were found to be highly specific for RRD and absent in ERD.

Conclusions:

  • Outer retinal corrugations (ORCs) are a highly specific OCT finding for rhegmatogenous retinal detachment (RRD), absent in exudative retinal detachment (ERD).
  • Differences in subretinal fluid content likely underlie the distinct OCT morphologies observed between ERD and RRD.
  • Recognizing these OCT features can improve the diagnostic accuracy and guide the management of ERD versus RRD.