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Orr S, Hatamnejad A, Sodhi S, Golding J, Pattathil N, Choudhry N. Novel features of degenerative retinoschisis identified using ultra-widefield multicolor channels: A review of 139 eyes. Acta Ophthalmol 2024; 102:e961-e969. [PMID: 38533620 DOI: 10.1111/aos.16683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND/OBJECTIVE To utilize ultra-widefield multimodal imaging (Optos PLC) to describe novel findings in degenerative retinoschisis. METHODS This retrospective, non-comparative case series of degenerative retinoschisis received a waiver of consent from Advarra IRB, Protocol 00066379. Initial ultra-widefield pseudocolour, colour-separated, autofluorescence, and peripheral OCT imaging were analysed for characterizing features. RESULTS In total, 139 eyes were included. A hyporeflective reticular pattern associated with retinoschisis was seen on pseudocolour images in 39% of cases, but visible in 53% on green-separated images. Fine hyper-reflective foci were observed in 49%. In 27%, retinoschisis was confirmed with OCT. CONCLUSIONS Ultra-widefield pseudocolour and green-separated images are valuable for the diagnosis and characterization of degenerative retinoschisis. The findings described may prompt the evaluation of subtle retinoschisis with peripheral OCT.
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Affiliation(s)
- Samantha Orr
- Vitreous Retina Macula Specialists of Toronto, Toronto, Ontario, Canada
- Octane Imaging Lab, Toronto, Ontario, Canada
| | - Amin Hatamnejad
- Octane Imaging Lab, Toronto, Ontario, Canada
- McMaster University, Hamilton, Ontario, Canada
| | - Simrat Sodhi
- Octane Imaging Lab, Toronto, Ontario, Canada
- University of Cambridge, Cambridge, UK
| | - John Golding
- Vitreous Retina Macula Specialists of Toronto, Toronto, Ontario, Canada
- Octane Imaging Lab, Toronto, Ontario, Canada
| | - Niveditha Pattathil
- Vitreous Retina Macula Specialists of Toronto, Toronto, Ontario, Canada
- Octane Imaging Lab, Toronto, Ontario, Canada
| | - Netan Choudhry
- Vitreous Retina Macula Specialists of Toronto, Toronto, Ontario, Canada
- Octane Imaging Lab, Toronto, Ontario, Canada
- Department of Ophthalmology & Visual Sciences, University of Toronto, Toronto, Ontario, Canada
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Pigmentary lesions in eyes with rhegmatogenous retinal detachment with flap tears: a retrospective observational study. Sci Rep 2022; 12:12470. [PMID: 35864144 PMCID: PMC9304380 DOI: 10.1038/s41598-022-16508-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 07/11/2022] [Indexed: 11/15/2022] Open
Abstract
We included 97 patients with unilateral rhegmatogenous retinal detachment (RRD) with posterior vitreous detachment who underwent vitrectomy, and examined pigmentary lesion (PL) characteristics around the sites of original tears using pre- and postoperative ultra-widefield scanning light ophthalmoscopy, green light fundus autofluorescence (FAF) imaging, and intraoperative digital video. If PL did not involve RRD, we used OCT to preoperatively assess any pathologic changes to the lesion. A total of 116 retinal tears (mean count, 1.2 ± 0.5; range, 1–4 per eye) were observed in the detached retina. Overall, 102 (88%), 63 (54%), 14 (12%), and 25 (22%) tears were accompanied by lattice degeneration (LD) or PL, both LD and PL, only LD, and only PL, respectively. In green FAF images, LD showed normal to mild-hyper fluorescence, whereas all PL showed hypofluorescence. On OCT, PL were located at the RPE level, while choroid abnormalities were unclear. In the retinal areas of 22 eyes, which were not affected by RRD, we observed PL without retinal tears; some were accompanied by vitreous traction and tractional retinal detachment. Pre-, intra-, and post-operative assessments of original flap tears suggested that PL might be a risk factor for RRD, developing alongside or separately from LD.
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Autofluorescence Imaging in the Long-Term Follow-Up of Scleral Buckling Surgery for Retinal Detachment. J Ophthalmol 2022; 2022:2119439. [PMID: 35265365 PMCID: PMC8898876 DOI: 10.1155/2022/2119439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 01/29/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose To analyse fundus autofluorescence (AF) changes in retinal reattachment following primary scleral buckling (SB) surgery for rhegmatogenous retinal detachment (RRD). Methods Prospective noninterventional chart review study. AF images were reviewed for peripheral and central changes and compared to clinical and OCT findings. Results A total of 73 eyes from 69 patients were included, four presenting with bilateral RRD. Mean age was 55 ± 12 years, male/female ratio 40/29, fovea-on/-off RRD 43/30, and mean follow-up time 376 ± 270 days, with a mean of 5 ± 3 postoperative visits. Preoperatively, RRD was seen as a hypofluorescent area with a hyperfluorescent leading edge. Immediately postoperatively, three types of cryopexy could be differentiated, gradually transforming to scleral hyperfluorescence. Buckle tightening produced alternating hyper-/hypofluorescent streaks, and demarcation lines showed a persistent rugged hyperfluorescent signal. Choroidal detachment led to transient hypofluorescence, whereas vortex vein compression induced persistent hypofluorescence. Peripheral retinal folds were hyperfluorescent and the drainage site was hypofluorescent. AF was highly sensitive in detecting even small amounts of hyperfluorescent persistent subretinal fluid (SRF) that showed a slow resolution during follow-up. A granular “salt-and-pepper-” like pattern in the central macula was seen in 80% of eyes with fovea-off RRD and alternating streaks in 10%. Findings from OCT imaging correlated well with AF regarding SRF, macular oedema, retinal pigment epithelial detachment, and presence of a subretinal scar, but only moderately in epiretinal membrane formation and choroidal folds. Conclusions AF is a useful, noninvasive, adjuvant tool in the long-term follow-up after SB surgery.
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Feng B, Su W, Chen Q, Gan R, Wang M, Wang J, Zhang J, Yan X. Quantitative Analysis of Retinal Vasculature in Rhegmatogenous Retinal Detachment Based on Ultra-Widefield Fundus Imaging. Front Med (Lausanne) 2022; 8:797479. [PMID: 35118092 PMCID: PMC8804160 DOI: 10.3389/fmed.2021.797479] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/16/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose To quantitatively analyze retinal vascular morphological features, such as vascular density, caliber, and tortuosity, in rhegmatogenous retinal detachment (RRD). Methods A total of 244 patients with RRD and 400 healthy controls (HC) were included. Retinal fundus images were collected using OPTOS PLC Daytona P200T. Retinal images were divided into RRD and non-RRD regions of interest (ROIs). All visible retinal fundus vessels were then extracted mainly based on edge detection within ROI to form the whole-vascular image. Retinal vasculature parameters, such as vascular density, caliber, and tortuosity, were calculated. Results For the absolute density, the mean rank (MR) value of normal controls was significantly higher than that in non-RRD (p < 0.001). A consistent tendency of significant vascular density was increased from non-RRD to RRD (p < 0.001). The average and median diameters of normal controls were both significantly larger than RRD (p < 0.001). The average and median diameters were also appeared significantly thinner in non-RRD. Unweighted and width-inversely-weighted vascular tortuosity in RRD and non-RRD comparison exhibited non-significant differences. All types of tortuosity calculated from HC were significantly larger (p < 0.001) in values compared to RRD. All types of tortuosity values of HC were significantly higher than non-RRD. Compared with non-RRD, RRD was significantly larger in area-weighted, length-weighted, and width-weighted vascular tortuosity. Conclusions This study showed that RRD affects both the quantity and morphology of retinal vasculature, such as RRD and non-RRD areas. Smaller average and medium vascular diameters and tortuosity values were found in RRD. However, the absolute vascular density, the average and median diameter, and tortuosity values were also reduced in non-RRD although the retina is still attached. This work indicates that RRD may affect the retinal vasculature beyond the detached retina.
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Affiliation(s)
- Bingkai Feng
- Shenzhen Key Laboratory of Ophthalmology, Shenzhen Eye Hospital, Shenzhen Eye Hospital Affiliated to Jinan University, Jinan University, Shenzhen, China
| | - Wenxin Su
- Institutes of Brain Science, State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
- Department of Psychology, University of Essex, Colchester, United Kingdom
| | - Qingshan Chen
- Shenzhen Key Laboratory of Ophthalmology, Shenzhen Eye Hospital, Shenzhen Eye Hospital Affiliated to Jinan University, Jinan University, Shenzhen, China
| | - Run Gan
- Shenzhen Key Laboratory of Ophthalmology, Shenzhen Eye Hospital, Shenzhen Eye Hospital Affiliated to Jinan University, Jinan University, Shenzhen, China
| | - Mingxuan Wang
- Institutes of Brain Science, State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Jiantao Wang
- Shenzhen Key Laboratory of Ophthalmology, Shenzhen Eye Hospital, Shenzhen Eye Hospital Affiliated to Jinan University, Jinan University, Shenzhen, China
- *Correspondence: Jiantao Wang
| | - Jiayi Zhang
- Institutes of Brain Science, State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
- Jiayi Zhang
| | - Xiaohe Yan
- Shenzhen Key Laboratory of Ophthalmology, Shenzhen Eye Hospital, Shenzhen Eye Hospital Affiliated to Jinan University, Jinan University, Shenzhen, China
- Xiaohe Yan
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Ness S, Subramanian ML, Chen X, Siegel NH. Diagnosis and Management of Degenerative Retinoschisis and Related Complications. Surv Ophthalmol 2021; 67:892-907. [PMID: 34896193 DOI: 10.1016/j.survophthal.2021.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 12/03/2021] [Accepted: 12/06/2021] [Indexed: 10/19/2022]
Abstract
Degenerative retinoschisis is a common condition characterized by elevation of the inner layers of the peripheral retina. While uncomplicated retinoschisis (i.e. with no associated retinal layer breaks) is almost invariably a benign process, retinal detachment associated with isolated outer layer breaks (termed schisis-detachment) is fairly common. Historically, schisis-detachment has been treated with a variety of interventions ranging from retinopexy to intraocular surgery. Based on published descriptions of the natural history of the disease, these interventions are likely unnecessary in many cases and may place the patient's vision at unnecessary risk. Progressive symptomatic schisis-related retinal detachment, on the other hand, is a vision threatening condition that requires intervention. While clinical examination remains the mainstay of diagnosis, recent advances in multimodal imaging can provide supplemental information in subtle cases and may prove valuable for long-term disease monitoring. When evaluating patients with peripheral retinal elevation, it is important for ophthalmologists to make an accurate diagnosis and understand the risk-benefit ratio associated with intervention. Thus, we summarize the current literature on the natural history, clinical and imaging diagnosis, and surgical management of degenerative retinoschisis and its related complications.
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Affiliation(s)
- Steven Ness
- Retina Service, Department of Ophthalmology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
| | - Manju L Subramanian
- Retina Service, Department of Ophthalmology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Xuejing Chen
- Retina Service, Department of Ophthalmology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Nicole H Siegel
- Retina Service, Department of Ophthalmology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
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