Structural Correlation of Spectral Domain OCT and Fundus Autofluorescence (FAF) of the Macula, Following Successful Surgical Repair of Rhegmatogenous Retinal Detachment

Abstract
Background: Macular recovery after surgery for retinal detachment depends on pre-operative and post-operative predictive factors. Pre-operative factors, which influence macular recovery negatively, include duration of macular detachment, height of macular detachment and vitreomacular traction. Post-operative factors, which influence macular recovery negatively, include cystoid macular edema, epiretinal membranes, retinal folds, subretinal Retinal Pigment Epithe-lium (RPE) migration and persistent subretinal fluid.
OCT has elucidated several postoperative factors corre-lating with poor vision. These features include persistent SRF and increased foveal thickness ,demonstrating as well the submacular fluid that couldn't be detected clinically. OCT can detect persistent foveal detachment, distortion and disruption of Outer Retinal Layers (ORLs) and macular folds following successful surgery for RD. FAF has been used to investigate the morphological and functional changes occurring after RD repair.
Objective: The aim of our study is to correlate the struc-ture-function relationship of the macula following successful repair of rhegmatogenous retinal detachment, by correlating the SD-OCT and FAF macular images with BCVA.
Study Design: Prospective observational case series study.
Patients and Methods: Forty-five eyes underwent surgical repair of RRD followed by SD-OCT and FAF imaging one to three months post-operative. SD-OCT and FAF findings were correlated with post-operative BCVA.
Results: Forty-five eyes achieved complete post-operative reattachment with 95.6% SOSR. The values of BCVA showed significant difference between eyes with the following OCT findings: Macular edema, persistent SRF, RPE-choriocapillaries complex, IS/OS junction disruption and neurosensory detach-ment and eyes not showing the same OCT changes (p 0.05).
The values of BCVA showed significant difference be-tween eyes showing hyper-autofluorescence on FAF imaging and eyes not showing hyper-autofluorescence (p=0.015).
We found significant association between fundus hyper-autofluorescence and the following OCT findings: Macular edema, RPE-choriocapillaries complex irregularity, IS/OS junction disruption and neurosensory detachment.
Conclusion: SD-OCT is considered a valuable tool for evaluating the microstructural changes at the macula. The IS/OS junction disruption, persistent SRF, macular edema, neurosensory detachment and RPE-choriocapillaries complex irregularity are considered vital measures affecting the structure and function of the macula and can explain the incomplete visual recovery despite an anatomical successful RD surgery. Fundus autofluorescence is a non-invasive imaging modality that evaluates the function and health of the photoreceptor and the RPE layers showing great advantage in analyzing the macular function abnormality.