Longitudinal study of macular folds by spectral-domain optical coherence tomography.

PURPOSE

To understand the natural history of macular folds using serial spectral-domain optical coherence tomography (SD-OCT).

DESIGN

Prospective case series.

METHOD

Serial OCTs were performed using Topcon 3D OCT. The main outcome measures were: patient demographics; preoperative, perioperative, and postoperative details; serial SD-OCTs; and length of follow-up.

RESULTS

Ten patients who underwent standard 3-port pars plana vitrectomy with gas tamponade to repair rhegmatogenous retinal detachment were included in this study. Mean follow-up was 9.9 months (range 5-17 months). Three types of retinal folds were identified: 1) ripple; 2) taco; 3) displacement. Ripple and taco folds were found to resolve spontaneously. Outer retinal hyperreflective lesions resolved first, followed by flattening of the inner retinal layers. Displacement folds also resolved, but left the macula translocated inferiorly, causing binocular diplopia.

CONCLUSION

Ripple and taco folds could be managed conservatively with good outcomes. However, the optimal treatment of displacement folds requires further research.