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Single-capture ultra-widefield guided swept-source optical coherence tomography in the management of rhegmatogenous retinal detachment and associated peripheral vitreoretinal pathology
  1. Wei Wei Lee1,
  2. Rajeev H Muni1,2
  1. 1Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
  2. 2Department of Ophthalmology, Unity Health Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Rajeev H Muni, Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada; rajeev.muni{at}gmail.com

Abstract

Background/Aim To assess the utility of single-capture ultra-widefield confocal scanning laser ophthalmoscope with integrated swept-source optical coherence tomography (UWF-SS-OCT) in the management of rhegmatogenous retinal detachment (RRD) and associated peripheral pathology.

Methods 138 eyes of 101 consecutive patients with RRD and/or associated peripheral pathology at a vitreoretinal practice in Toronto, Canada between December 2020 and February 2021 that had UWF-SS-OCT with interpretable scans were included. A 200 degree fundus photograph was used to navigate a built-in 100 kHz UWF-SS-OCT to image pathology with a high-density 23 mm line scan and/or volume scan. Main outcomes were the microstructural details of the RRD and/or associated peripheral pathology and longitudinal assessment of response to laser retinopexy and cryopexy with UWF-SS-OCT.

Results 56.5% (78/138) of eyes had prior or current RRD (6 eyes had combined retinoschisis detachment), 31.1% (43/138) had retinal tears/holes and 14.5% (20/138) had lattice degeneration. UWF-SS-OCT impacted management and was useful in determining the presence or absence of vitreoretinal traction with retinal holes or tears. It was also helpful in differentiating retinal detachment, schisis-detachment and retinoschisis in cases where it was not apparent clinically. There were also several novel findings such as vitreous adhesion at the posterior border of a retinal dialysis. UWF-SS-OCT was performed longitudinally before and immediately following laser retinopexy (n=22) and cryopexy (n=4). Microstructural changes were consistent with chorioretinal adhesion immediately following laser versus postprocedure day 6 following cryopexy.

Conclusion Single-capture UWF-SS-OCT enabled novel insights in RRD and associated peripheral vitreoretinal pathology.

  • retina
  • imaging
  • diagnostic tests/investigation
  • vitreous
  • choroid

Data availability statement

All data relevant to the study are included in the article or uploaded as supplemental information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplemental information.

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Footnotes

  • Contributors WWL conceptualised and designed the work and data collection tools, performed data collection for the whole trial, cleaned and analysed the data, drafted the paper and approved the final version to be published. RHM conceptualised and designed the work, monitored data collection, analysed the data, performed critical revision of the draft paper and approved the final version to be published. RHM is also acting as guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.