Spectral Domain-Optical Coherence Tomography Study of Retinas With a Normal Foveal Contour and Thickness After Retinal Detachment Surgery

PURPOSE: The purpose was to study the disruption of the inner segment (IS) and outer segment (OS) junction associated with suboptimal visual outcome after successful retinal detachment surgery with an otherwise normal foveal contour and thickness. MATERIALS AND METHODS: A comparative study of 2 groups, i.e., group I-suboptimal visual outcome (visual acuity <20/40) and group II-optimal visual outcome (visual acuity> or =20/40), with 7 eyes of 7 patients in each group rhegmatogenous retinal detachment surgery with an otherwise normal foveal contour and thickness on spectral domain-optical coherence tomography was evaluated for disruption of the IS and OS junction at 6 weeks using the crosshair protocol through the fovea. A 5 x 5-mm grid raster protocol (E MM5)imaged 256 squares of retina and the number of squares with IS and OS junction disruption was correlated with best-corrected visual acuity. RESULTS: Disruption of the IS and OS junction was seen in all 7 eyes of group I (100%)compared with 2 eyes in group II (28%), which was an obvious statistical difference (P =0.021). Also, a statistically significant correlation existed (r = 0.84, P < 0.05) when best-corrected visual acuity was plotted against the number of squares with IS and OS disruption. There was a statistically insignificant (P = 0.09) trend noted toward greater IS and OS junction disruption in eyes with prior macula off rhegmatogenous retinal detachments on univariate analysis. CONCLUSION: Disruption of the IS and OS junction could be a surrogate measure of the structural and functional health of the photoreceptors and can explain poor visual outcome in postsuccessful retinal detachment surgery with an otherwise normal foveal contour and thickness.