Posterior Hyaloid Status On OCT At Time Of RRD Useful Biomarker For RRD Risk In Fellow Eye

A recent retrospective review published in the journal American Academy Of Ophthalmology has shed light on the potential of optical coherence tomography (OCT) imaging in assessing the risk of rhegmatogenous retinal detachment (RRD) in the fellow eye of patients diagnosed with RRD. The study findings suggest that the presence or absence of a posterior vitreous detachment (PVD), as determined by OCT imaging, can offer valuable insights into the likelihood of RRD development in the fellow eye.

The research conducted by Josh O. Wallsh and team , which involved a comprehensive analysis of medical records, included 1049 patients diagnosed with RRD. The participants were followed up for an average of 5.7 years. The study focused on evaluating the posterior hyaloid status (PVD) in both eyes at the time of initial RRD and recording baseline characteristics such as lattice degeneration, refractive error, prior ocular laser procedures, lens status, and family history of RRD.

● A group of 1049 patients diagnosed with rhegmatogenous retinal detachment (RRD) were carefully monitored for an average duration of 5.7 ± 0.3 years.

● Among the participants, 153 individuals (14.6%) experienced bilateral sequential RRD during the follow-up period.

● For 582 fellow eyes, optical coherence tomography (OCT) imaging was available, revealing that 229 eyes (39.3%) had a posterior vitreous detachment (PVD), while 353 eyes (60.7%) still had an attached hyaloid.

● Only 7 fellow eyes (3.1%) with an initial PVD developed RRD.

● Conversely, within the group of fellow eyes with an attached hyaloid, 28 eyes (7.9%) exhibited RRD over the follow-up period.

● When focusing solely on those eyes where a PVD developed during follow-up, a significant 23.7% of such eyes were found to develop RRD.

● At the time of PVD development in the fellow eye, an additional 21 eyes (17.8%) were noted to have a retinal tear, which was effectively treated without progressing to RRD.

These findings highlight the importance of OCT imaging in assessing the risk of RRD in fellow eyes of patients with the condition. The presence or absence of PVD and the status of the posterior hyaloid can provide valuable insights into the likelihood of RRD development.

Specifically, fellow eyes with a visible posterior hyaloid require close monitoring upon PVD occurrence, as they demonstrate a higher risk of RRD compared to those with a completely detached posterior hyaloid.

This study emphasizes the potential of OCT imaging as a valuable tool for risk stratification in RRD cases. By utilizing OCT imaging to identify individuals at higher risk of RRD, healthcare professionals can develop more targeted monitoring and management strategies, potentially leading to earlier detection and intervention. This, in turn, may contribute to reducing the risk of vision loss associated with RRD.

Further research and validation of these findings are necessary to establish OCT imaging as a routine practice in assessing the risk of RRD in patients with initial RRD. However, the study's results offer valuable insights into the potential benefits of early detection and intervention in preventing vision loss caused by retinal detachment.

Reference:

Wallsh, J. O., Langevin, S. T., Kumar, A., Huz, J., Falk, N. S., & Bhatnagar, P. (2023). Fellow-eye retinal detachment risk as stratified by hyaloid status on OCT. Ophthalmology, 130(6), 624–630. https://doi.org/10.1016/j.ophtha.2023.02.004.