4.4 Article

EVALUATION OF PARAVASCULAR INNER RETINAL DEFECTS USING EN FACE OPTICAL COHERENCE TOMOGRAPHY

Journal

RETINA-THE JOURNAL OF RETINAL AND VITREOUS DISEASES
Volume 43, Issue 10, Pages 1644-1652

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/IAE.0000000000003889

Keywords

paravascular inner retinal defects; en face OCT; posterior vitreous detachment; epiretinal membrane; paravascular retinal cysts; paravascular lamellar holes; retinoschisis

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This study evaluated the prevalence and risk factors for the development of paravascular inner retinal defects (PIRDs) using en face optical coherence tomography. The results showed that en face optical coherence tomography effectively identified PIRDs and their presence was significantly associated with posterior vitreous detachment, epiretinal membrane, and retinoschisis.
Purpose: To evaluate the prevalence and risk factors for development of paravascular inner retinal defects (PIRDs) using en face optical coherence tomography.Methods: This is a retrospective cross-sectional study. En face and cross-sectional optical coherence tomography images were reviewed (9 x 9 mm or 12 x 12 mm). Paravascular inner retinal defects were classified as either Grade 1 (i.e., paravascular inner retinal cysts) when the lesion was confined within the nerve fiber layer without any communication to the vitreous cavity or Grade 2 (i.e., paravascular lamellar hole) when the defects communicated to the vitreous. Paravascular inner retinal defect grading was correlated with presence of high myopia, stage of posterior vitreous detachment, and presence of epiretinal membrane and retinoschisis.Results: Of 1,074 patients (2,148 eyes), PIRDs were detected in 261 eyes with a prevalence of 261 per 2,148 eyes (12.2%) and 176 per 1,074 patients (16.4%). A total of 116 eyes (44.4%) displayed Grade 2 PIRDs while 145 eyes (55.6%) were Grade 1. In the multivariate logistic regression model, the presence of partial/complete posterior vitreous detachment, retinoschisis, and epiretinal membrane was significantly correlated with PIRDs (OR = 2.78 [1.7-4.4], P < 0.001; OR = 2.93 [1.7-5], P< 0.001; and OR = 25.9 [2.8-242.5], P < 0.001, respectively). The presence of partial/complete posterior vitreous detachment and epiretinal membrane was also significantly associated with Grade 2 PIRDs versus Grade 1 PIRDs (P = 0.03 and P < 0.001).Conclusion: Our results indicate that wide-field en face optical coherence tomography facilitates the identification of PIRDs over a large area of retina with a single capture. The presence of PIRDs was significantly associated with posterior vitreous detachment, epiretinal membrane, and retinoschisis, confirming the role of vitreoretinal traction in the pathogenesis of PIRDs.

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