Abstract

Objective: To evaluate the morphologic changes in the macula of subjects with repaired macula-off retinal detachment using high-resolution Fourier-domain optical coherence tomography and to perform functional correlation in a subset of patients using microperimetry. Design: Prospective observational case series. Participants: Seventeen eyes from 17 subjects who had undergone anatomically successful repair for macula-off, rhegmatogenous RD at least 3 months earlier and without visually significant maculopathy on funduscopy. Methods: FD OCT with axial and transverse resolution of 4.5 μm and 10 to 15 μm, respectively, was used to obtain rapid serial B-scans of the macula, which were compared with that from Stratus OCT. The FD OCT B-scans were used to create a 3-dimensional volume, from which en face C-scans were created. Among 11 patients, MP-1 was performed to correlate morphologic changes with visual function. Main Outcome Measures: Stratus OCT scans, FD OCT scans, and MP-1 data. Results: Stratus OCT and FD OCT images of the macula were obtained 3 to 30 months postoperatively in all eyes. Although Stratus OCT revealed photoreceptor disruption in 2 eyes, FD OCT showed photoreceptor disruption in 13 eyes. This difference was statistically significant. Both imaging modalities revealed persistent subretinal fluid in 2 eyes and lamellar hole in 1 eye. Among 7 subjects who had reliable MP-1 data, areas of abnormal function corresponded to areas of photoreceptor layer disruptions or persistent subretinal fluid in 5 subjects ; one subject had normal FD OCT and MP-1. Conclusions: Photoreceptor disruption after macula-off RD repair is a common abnormality in the macula that is detected better with FD OCT than Stratus OCT. A good correlation between MP-1 abnormality and presence of photoreceptor disruption or subretinal fluid on FD OCT demonstrates that these anatomic abnormalities contribute to decreased visual function after successful repair. Financial Disclosure: The authors have no proprietary or commercial interest in any materials discussed in this article. © 2008 American Academy of Ophthalmology.