Clinical Ophthalmology (Aug 2024)

Morphological and Clinical Characterization of Foveal Bulge Sign Three Years After Retinal Detachment Repair: A Longitudinal Prospective Evaluation

  • Arend N,
  • Vounotrypidis E,
  • Schumann RG,
  • Kampik A,
  • Lob F,
  • Priglinger S,
  • Wolf A

Journal volume & issue
Vol. Volume 18
pp. 2261 – 2270

Abstract

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Nicole Arend,1,* Efstathios Vounotrypidis,2,* Ricarda G Schumann,3 Anselm Kampik,3 Felice Lob,4 Siegfried Priglinger,5 Armin Wolf2 1Department of Ophthalmology, Eye Center Olching, Olching, Germany; 2Department of Ophthalmology, Ulm University, Ulm, Germany; 3Munich Eye Center “Augenzentrum im Brienner Hof”, Munich, Germany; 4Department of Ophthalmology, Realeyes Eye clinic, Munich, Germany; 5Department of Ophthalmology, Ludwig Maximilian University, Munich, Germany*These authors contributed equally to this workCorrespondence: Armin Wolf, Department of Ophthalmology Ulm University, Ulm, Germany, Email [email protected]: To evaluate optical-coherence-tomography (OCT)-morphological and clinical parameters three years after primary rhegmatogenous retinal detachment (RRD) repair surgery and the role of postoperative foveal bulge sign.Methods: Of the 32 initially enrolled patients with primary RRD 20 (14 fovea-on, 6 fovea-off) completed this prospective study. Preoperatively and 3 years after surgery best corrected visual acuity (BCVA) and OCT including macula status, central retinal thickness (CRT), central choroidal thickness (CCT), thickness of each single retinal layer, integrity of cone-interdigitation-zone (CIZ) and ellipsoid zone (EZ), and presence of foveal bulge were evaluated.Results: Preoperatively fovea-off RRD patients show significantly thinner CCT, inner nuclear layer (INL) and inner plexiform layer (IPL) compared to fovea-on RRD patients, whereas only IPL and INL were significantly thicker compared to the fellow eye. Three years after surgery this thickening recovered. Final BCVA did not differ statistically significantly between fovea-off and fovea-on patients, no difference in CIZ-integrity or presence of foveal bulge was observed. Presence of foveal bulge at 3 years showed significantly better final BCVA and was associated with intact preoperative CIZ-integrity and postoperative EZ- and CIZ-integrity. The preoperative fovea status showed no correlation to the postoperative presence of foveal bulge.Conclusion: Three years after RRD repair retinal layers show similar thickness. The presence of foveal bulge is associated with better final BCVA. Sufficient pre- and postoperative CIZ-integrity as well as postoperative CIZ-integrity seem to be strongly associated with the restoration of foveal bulge. No correlation was found with the preoperative macular status or BCVA.Plain Language Summary: We analyzed long-term optical-coherence-tomography changes after rhegmatogenous retinal detachment repair. Three years after rhegmatogenous retinal detachment repair retinal layers show similar thickness and visual acuity did not differ between fovea off and fovea on patients. The restoration of foveal bulge sign was the most important factor for good postoperative visual acuity. Integrity of specific retinal layers, such as the ellipsoid zone and cone-interdigitation-zone, seems to be strongly associated with the restoration of the foveal bulge.Keywords: retinal detachment, visual acuity, optic coherence tomography, foveal bulge, retinal layers, retinal thickness, visual outcome, OCT

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