Simultaneous spectral domain OCT and fundus autofluorescence imaging of the macula and microperimetric correspondence after successful repair of rhegmatogenous retinal detachment

Background/aims To evaluate the ultrastructural changes in the macula after successful repair of rhegmatogenous retinal detachment (RRD) using simultaneous spectral domain optical coherence tomography (sdOCT) and fundus autofluorescence (FAF) imaging and to perform functional correlations with microperimetry. Methods Simultaneous sdOCT and FAF imaging were performed using a combined sdOCT-confocal scanning laser ophthalmoscope (cSLO) system. Microperimetry was performed in a subgroup of these patients. Results 17 patients with macular-on RRD and 20 with macular-off RRD were recruited. sdOCT images revealed disruption of the external limiting membrane, inner segment/outer segment junction or the Verhoeff membrane in 16 eyes (43.2%). The presence of any or more of these disruptions was significantly associated with a poor postoperative best-corrected visual acuity (BCVA) (p<0.001). Patients with abnormal FAF were also associated with poor postoperative BCVA (p<0.001). However, there was a generally poor correspondence between the localisation of ultrastructural abnormalities as detected by sdOCT and FAF changes. Areas of decreased microperimetric sensitivity corresponded well with the ultrastructural changes and abnormal FAF. Conclusions FAF changes may lag behind ultrastructural changes in the OCT, some of which may reverse with the passage of time. The present study demonstrates the ultrastructural changes assessed with simultaneous FAF and sdOCT and their relation with visual outcome.