Widefield imaging of the peripheral vitreoretinal interface in patients with horseshoe tear and rhegmatogenous retinal detachment

Author: Mariiam Taevere (Russian Federation)

Co-authors: Alexander Doga, Leonid Kryl, Dmitriy Buryakov

Purpose

Surgical treatment of rhegmatogenous retinal detachment (RRD) is aimed to relieve the main pathogenetic factor – vitreoretinal tractions (VRT). The development of modern diagnostic instruments provided the possibility to reveal areas of VRT and vitreoretinal adhesion (VRA) with widefield methods of retinal visualization. The study aimed to evaluate the peripheral vitreoretinal interface in patients with a horseshoe retinal tear and RRD with widefield methods of diagnostics.

Setting/Venue

S. Fyodorov Eye Microsurgery Federal State Institution, 59а, Beskoudnikovsky blvd, Moscow, 127486, Russian Federation.

Methods

The study included 88 patients (88 eyes) with a horseshoe retinal tear; 45 of them had isolated horseshoe tear and 43 patients had RRD developed due to the horseshoe tear. In addition to the standard ophthalmologic examinations, all patients underwent widefield diagnostics including optical coherent tomography (WF-OCT), multi-spectral laser scanning, and infrared video registration. All the diagnostic procedures were performed using “Spectralis HRA+OCT” (“Heidelberg Engineering Inc.”, Germany) with a 55º lens. Differentiation of horseshoe tears was performed by their shape with a method of hierarchical clustering. The horseshoe tear shape was determined as the length to width ratio of the tear (l/b). Further, a correlation between the shape of a retinal tear and the length of VRA was established using Spearman’s correlation analysis. Furthermore, the analysis of the RRD development probability was performed based on the shape of a retinal tear.

Results

The mean age of patients was 52.13 ± 8.94 years old. Ward’s dendrogram revealed 4 shapes of retinal tears. Each kind of shape corresponded with a certain localization of VRA. The Spearman’s correlation analysis have found that there was a strong negative correlation between the shape of a retinal tear and the length of VRA. The low l/b ratio was associated with a high probability of the RRD development.

Conlusions

Widefield diagnostic methods allow a morphometrical evaluation of the peripheral vitreoretinal interface and identification of the VRA localization. The revealed correlations can help an ophthalmologist to identify the localization of VRA based on the shape of the retinal tear, evaluate the risks of the RRD development, and choose the treatment tactics even in cases when the WF-OCT is not available.