Quantification of cone loss after surgery for retinal detachment involving the macula using adaptive optics

Aims To image the cones in eyes with anatomically successful repair of retinal detachment (RD) involving the macula and in healthy fellow eyes using an adaptive optics (AO) camera and to correlate the results to clinical outcomes. Methods Twenty-one patients (42 eyes) operated for macula-off RD were imaged 6 weeks after surgery using an AO camera (RTX 1, Imagine Eyes, Orsay, France). Cone density (cells/mm2), spacing between cells (µm) and the percentage of cones with six neighbours were measured. Best-corrected visual acuity (BCVA) and thickness of the inner segment ellipsoid (ISe) band imaged by SD-optical coherence tomography were also measured. Results The parafoveal cone density was decreased in eyes operated for RD (mean±SD 14 576±4035/mm2) compared with fellow eyes (20 589±2350/mm2) (p=0.0001). There was also an increase in cone spacing (10.3±2.6 vs 8.0±1.0.9 µm, respectively, p<0.0001). The nearest-neighbour analysis revealed a reduction in the percentage of cones with six neighbours (36.5±4.2 vs 42.7±4.6%, p=0.0003). The ISe thickness, thinner in the operated eyes, was correlated to the cone density (r=0.62, p<0.0001). BCVA was significantly correlated to cone density (r=0.8, p<0.001). Conclusions There was a decrease in the cone density after RD with an estimated loss of one-third of the cones. Postoperative visual acuity was highly correlated with the cone density. AO may be a valuable prognostic tool after RD surgery.

[1]  Michel Paques,et al.  Adaptive optics imaging of geographic atrophy. , 2013, Investigative ophthalmology & visual science.

[2]  Kaccie Y. Li,et al.  Intersubject variability of foveal cone photoreceptor density in relation to eye length. , 2010, Investigative ophthalmology & visual science.

[3]  R. Machemer Experimental retinal detachment in the owl monkey. II. Histology of retina and pigment epithelium. , 1968, American journal of ophthalmology.

[4]  Experimental Retinal Detachment in the Owl Monkey , 1968 .

[5]  A. Hendrickson,et al.  Human photoreceptor topography , 1990, The Journal of comparative neurology.

[6]  Masaaki Hanebuchi,et al.  Objective Assessment of Foveal Cone Loss Ratio in Surgically Closed Macular Holes Using Adaptive Optics Scanning Laser Ophthalmoscopy , 2013, PloS one.

[7]  Marco Lombardo,et al.  ADAPTIVE OPTICS IMAGING OF PARAFOVEAL CONES IN TYPE 1 DIABETES , 2014, Retina.

[8]  M. Stirpe,et al.  INTEROCULAR SYMMETRY OF PARAFOVEAL PHOTORECEPTOR CONE DENSITY DISTRIBUTION , 2013, Retina.

[9]  Masanori Hangai,et al.  High-resolution imaging of the photoreceptor layer in epiretinal membrane using adaptive optics scanning laser ophthalmoscopy. , 2011, Ophthalmology.

[10]  S. M. Williams,et al.  Anatomical Distribution of Rods and Cones , 2001 .

[11]  D. Charteris,et al.  Retinal detachment neuropathology and potential strategies for neuroprotection. , 2005, Survey of ophthalmology.

[12]  D. Anderson,et al.  Recovery of photoreceptor outer segment length and analysis of membrane assembly rates in regenerating primate photoreceptor outer segments. , 1993, Investigative Ophthalmology and Visual Science.

[13]  G. Lewis,et al.  Experimental retinal detachment in the cone-dominant ground squirrel retina: Morphology and basic immunocytochemistry , 2002, Visual Neuroscience.

[14]  D. Anderson,et al.  Morphological recovery in the reattached retina. , 1986, Investigative ophthalmology & visual science.

[15]  A. Tsujikawa,et al.  High-resolution imaging of resolved central serous chorioretinopathy using adaptive optics scanning laser ophthalmoscopy. , 2010, Ophthalmology.

[16]  Adrian Gh. Podoleanu,et al.  Combinations of techniques in imaging the retina with high resolution , 2008, Progress in Retinal and Eye Research.

[17]  D. Chen,et al.  Photoreceptor apoptosis in human retinal detachment. , 2005, American journal of ophthalmology.

[18]  Y. Tano,et al.  Foveal microstructure and visual acuity after retinal detachment repair: imaging analysis by Fourier-domain optical coherence tomography. , 2009, Ophthalmology.

[19]  J. Sebag,et al.  Apoptotic photoreceptor cell death after traumatic retinal detachment in humans. , 1996, Archives of ophthalmology.

[20]  Y. Kurimoto,et al.  The significance of cone outer segment tips as a prognostic factor in epiretinal membrane surgery. , 2012, American journal of ophthalmology.

[21]  Geoffrey P. Lewis,et al.  Cellular remodeling in mammalian retina: results from studies of experimental retinal detachment , 2005, Progress in Retinal and Eye Research.

[22]  Jan Flusser,et al.  Image registration methods: a survey , 2003, Image Vis. Comput..

[23]  M. Inoue,et al.  Correlation between length of foveal cone outer segment tips line defect and visual acuity after macular hole closure. , 2012, Ophthalmology.

[24]  K. Takayama,et al.  Photoreceptor damage and foveal sensitivity in surgically closed macular holes: an adaptive optics scanning laser ophthalmoscopy study. , 2012, American journal of ophthalmology.

[25]  T. Burton Recovery of visual acuity after retinal detachment involving the macula. , 1982, Transactions of the American Ophthalmological Society.

[26]  G. Kroemer,et al.  Critical role of photoreceptor apoptosis in functional damage after retinal detachment , 2002, Current eye research.

[27]  B. Stuck,et al.  Steroidal and nonsteroidal antiinflammatory medications can improve photoreceptor survival after laser retinal photocoagulation. , 2007, Ophthalmology.

[28]  A. Lecleire-Collet,et al.  Evaluation of macular changes before and after successful retinal detachment surgery using stratus-optical coherence tomography. , 2006, American journal of ophthalmology.