Título / Title

A MULTICENTER STUDY USING FUNDUS AUTOFLUORESCENCE IMAGING TO COMPARE QUALITY OF RETINAL REATTACHMENT IN PNEUMATIC RETINOPEXY VS. PARS PLANA VITRECTOMY

Introdução / Purpose

Fundus autofluorescence (FAF) can be used to assess the extent of retinal displacement following rhegmatogenous retinal detachment (RRD). The purpose of this study is to use FAF to compare the quality of anatomical success following RRD repair with pars plana vitrectomy (PPV) vs pneumatic retinopexy (PnR) and to determine the association between anatomical and functional outcomes.

Material e Método / Methods

A multicenter retrospective study across 3 sites in North America and the UK assessed the extent of displacement detected by retinal vessel displacement (RVP) on FAF at 3 months post-operatively by two masked graders. Eyes with good quality post-operative FAF imaging at 3 months were included. Patients with other retinal diseases that could influence the interpretation of FAF images were excluded. The primary outcome was the proportion of eyes with retinal displacement following PnR vs PPV. The association of RVP with objectively measured visual acuity (VA), aniseikonia and metamorphopsia were assessed.

Resultados / Results

214 eyes were included. 97 had PPV, 102 had PnR, 7 had SB+PPV and 8 had SB alone as the final procedure to achieve anatomical retinal reattachment. The proportion of eyes with RVP was 42.3% for PPV, 7.8% for PnR, 78% for SB+PPV and 12.5% for scleral buckle alone (p<0.001 for PnR vs PPV). Among eyes that had metamorphopsia measurements, 82.1% (23/28) of eyes in the +RVP group had objective vertical distortion vs 55% (60/109) in the -RVP group (p=0.009). 64.3% (18/28) of eyes in the +RVP group had horizontal distortion vs 57.8% (63/109) in the –RVP group (p=0.533). Objective anisekonia measurements were abnormal in 57.1% (16/28) in the +RVP group vs 49.0% (51/104) in the –RVP group (p=0.45). Mean logMAR VA was 0.50+-0.40) in the +RVP group vs 0.34+-0.34) in the –RVP group (p=0.009).

Discussão e Conclusões / Conclusion

The proportion of patients with RVP on FAF was significantly less in patients undergoing PnR vs PPV.

Palavras Chave

rhegmatogenous retinal detachment, fundus autofluorescence, pneumatic retinopexy, pars plana vitrectomy, metamorphopsia, retinal displacement