Department of Vitreo Retina, Aditya Jyot Eye Hospital, Mumbai, India.
Retina. 2010 May;30(5):724-32. doi: 10.1097/iae.0b013e3181cd47bb.
The purpose was to study the disruption of the inner segment (IS) and outer segment (OS) junction associated with suboptimal visual outcome after successful retinal detachment surgery with an otherwise normal foveal contour and thickness.
A comparative study of 2 groups, i.e., group I-suboptimal visual outcome (visual acuity <20/40) and group II-optimal visual outcome (visual acuity> or =20/40), with 7 eyes of 7 patients in each group rhegmatogenous retinal detachment surgery with an otherwise normal foveal contour and thickness on spectral domain-optical coherence tomography was evaluated for disruption of the IS and OS junction at 6 weeks using the crosshair protocol through the fovea. A 5 x 5-mm grid raster protocol (E MM5)imaged 256 squares of retina and the number of squares with IS and OS junction disruption was correlated with best-corrected visual acuity.
Disruption of the IS and OS junction was seen in all 7 eyes of group I (100%)compared with 2 eyes in group II (28%), which was an obvious statistical difference (P =0.021). Also, a statistically significant correlation existed (r = 0.84, P < 0.05) when best-corrected visual acuity was plotted against the number of squares with IS and OS disruption. There was a statistically insignificant (P = 0.09) trend noted toward greater IS and OS junction disruption in eyes with prior macula off rhegmatogenous retinal detachments on univariate analysis.
Disruption of the IS and OS junction could be a surrogate measure of the structural and functional health of the photoreceptors and can explain poor visual outcome in postsuccessful retinal detachment surgery with an otherwise normal foveal contour and thickness.
研究在 otherwise normal foveal contour 和厚度的视网膜脱离手术后，伴有次优视觉结果的内节（IS）和外节（OS）交界处的破坏情况，而这些病例的黄斑区均正常。
对 2 组（即 I 组：视觉结果不佳（视力<20/40）和 II 组：视觉结果良好（视力≥20/40））进行了比较研究，每组各有 7 例 7 只眼，均行 otherwise normal foveal contour 和 thickness 的孔源性视网膜脱离手术，在 6 周时，使用十字准线方案通过黄斑区，对 IS 和 OS 交界处的破坏情况进行了光谱域光学相干断层扫描（SD-OCT）评估。使用 5 x 5-mm 栅格方案（E MM5），对视网膜的 256 个正方形成像，并将存在 IS 和 OS 交界处破坏的正方形数量与最佳矫正视力相关联。
在 I 组的所有 7 只眼中（100%）都观察到了 IS 和 OS 交界处的破坏，而在 II 组中只有 2 只眼（28%），这是一个明显的统计学差异（P=0.021）。当将最佳矫正视力与存在 IS 和 OS 破坏的正方形数量进行比较时，也存在统计学上的显著相关性（r=0.84，P<0.05）。在单变量分析中，先前有黄斑脱离的孔源性视网膜脱离眼存在 IS 和 OS 交界处破坏的趋势更大，但无统计学意义（P=0.09）。
IS 和 OS 交界处的破坏可能是光感受器结构和功能健康的替代测量指标，可以解释在 otherwise normal foveal contour 和厚度的视网膜脱离手术后，视觉结果不佳的原因。
