En Face OCT in Diagnosis of Persistent Subretinal Fluid and Outer Retinal Folds after Rhegmatogenous Retinal Detachment Repair

Aditya Bansal; Hesham Hamli; Wei Wei Lee; David Sarraf; SriniVas Sadda; Alan R Berger; David T Wong; Peter J Kertes; Radha P Kohly; Roxane J Hillier; Rajeev H Muni

doi:10.1016/j.oret.2023.01.011

En Face OCT in Diagnosis of Persistent Subretinal Fluid and Outer Retinal Folds after Rhegmatogenous Retinal Detachment Repair

Ophthalmol Retina. 2023 Jun;7(6):496-502. doi: 10.1016/j.oret.2023.01.011. Epub 2023 Jan 19.

Authors

Affiliations

¹ Department of Ophthalmology and Vision Sciences, University of Toronto, Canada; Department of Ophthalmology, St. Michael's Hospital, Unity Health Toronto, Canada.
² Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California.
³ Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California; Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, California.
⁴ Department of Ophthalmology and Vision Sciences, University of Toronto, Canada; Kensington Vision and Research Centre, University of Toronto, Canada; The John and Liz Tory Eye Centre, Sunnybrook Health Sciences Centre, Canada.
⁵ Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom; Institute of Translational and Clinical Research, Newcastle University, United Kingdom.
⁶ Department of Ophthalmology and Vision Sciences, University of Toronto, Canada; Department of Ophthalmology, St. Michael's Hospital, Unity Health Toronto, Canada; Kensington Vision and Research Centre, University of Toronto, Canada; Keenan Research Centre for Biomedical Science, Toronto, Canada; Li Ka Shing Knowledge Institute, Toronto, Canada. Electronic address: rajeev.muni@gmail.com.

PMID: 36681191
DOI: 10.1016/j.oret.2023.01.011

Abstract

Purpose: To evaluate the role of en face OCT as a diagnostic tool for the detection of persistent subretinal fluid (PSRF) and outer retinal folds (ORFs) after successful rhegmatogenous retinal detachment (RRD) repair.

Design: Observational post hoc analysis of 2 prospective surgical trials.

Participants: All patients with gradable (signal strength ≥ 5 and no segmentation error) 6 × 6-mm² macular cube scans obtained using spectral-domain OCT (Carl Zeiss Meditec) between 1 and 2 months after surgery were included in this study.

Methods: The scans were assessed for the presence or absence of PSRF or ORFs using en face OCT and cross-sectional B scans by 2 masked graders, with any disagreements adjudicated by a third senior masked grader.

Main outcome measures: The sensitivity, specificity, and predictive accuracy (using area under the curve [AUC]) of en face OCT were compared with those of cross-sectional OCT, which is considered the gold standard.

Results: Two hundred twenty-three patients were included in this study. The Cohen kappa between the graders in the diagnosis of PSRF and ORFs using en face OCT was 0.84 and 0.86, respectively. The sensitivity of en face OCT was 100% (95% confidence interval [CI], 100%-100%) in the diagnosis of PSRF and 98.8% (95% CI, 96.5%-101.1%) in the diagnosis of ORFs. Similarly, the specificity of en face OCT was 98.7% (95% CI, 96.8%-100.5%) and 84.2% (95% CI, 78.1%-90.2%) in the diagnosis of PSRF and ORFs, respectively. The AUC was 0.99 for PSRF and 0.91 for ORFs.

Conclusions: En face OCT has good sensitivity, specificity, and predictive accuracy (using AUC) in the diagnosis of PSRF and ORFs. En face OCT is an efficient screening tool for postoperative anatomic abnormalities, such as PSRF and ORFs, after RRD repair.

Financial disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Keywords: ALIGN trial; En Face OCT; Outer Retinal Folds; PIVOT trial; Persistent Subretinal Fluid.

Publication types

Observational Study

MeSH terms

Cross-Sectional Studies
Humans
Prospective Studies
Retinal Detachment* / diagnosis
Retinal Detachment* / surgery
Retinal Diseases*
Subretinal Fluid
Tomography, Optical Coherence