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Intraoperative SD-OCT findings predict VA outcomes after PPV for macular hole repair

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TORONTO — Intraoperative spectral-domain optical coherence tomography during macula-involving detachment repair reveals persistent subretinal fluid in all patients under perfluoro-n-octane tamponade, a presenter here said.

Furthermore, intraoperative predictors of poor visual acuity outcomes included increased retinal thickness, increased outer retinal thickness and disorganized outer retina, but presence of fluid did not result in a statistically significant difference between good and poor visual acuity outcomes, Sunil K. Srivastava, MD, said at the American Society of Retina Specialists meeting.

Sunil K. Srivastava

Srivastava and colleagues undertook a retrospective review of 38 patients in the PIONEER study who had undergone pars plana vitrectomy to repair macula-involving retinal detachment and questioned whether or not the presence of subretinal fluid seen intraoperatively indicated changes in visual acuity over time.

“Previously we’ve shown persistence of subretinal fluid after instillation of Perfluoron and silicone oil, with resolution of the fluid postoperatively,” Srivastava said.

Preoperatively, 30 eyes had visual acuity of 20/200 or worse. Postoperatively, 17 eyes had visual acuity of 20/40 or better, and eight eyes had a visual acuity of 20/200 or worse, Srivastava said.

“Outer retina changes are where we saw the most significant change,” Srivastava said, with patients with good visual acuity having an average outer retinal thickness of about 94 microns in eyes with good visual acuity and 173 microns in eyes with poor visual acuity.

Good visual acuity was seen in patients with relatively normal retinal structures and thickness.

Disclosure: Srivastava is on the advisory board for, is a consultant for and/or receives research funding from Alimera, Bausch + Lomb, Clearside, Eleven, Novartis and Regeneron. Srivastava receives royalties from Bioptigen.