Sassen Sandrine H, Sassen Josua, Sassmannshausen Marlene, Goerdt Lukas, Liermann Yannick, Liegl Raffael G, Herrmann Philipp, Finger Robert P, Holz Frank G, Thiele Sarah
Department of Ophthalmology, University of Bonn, Bonn, Germany.
Institute for Numerical Simulation, University of Bonn, Bonn, Germany.
Invest Ophthalmol Vis Sci. 2025 Jul 1;66(9):32. doi: 10.1167/iovs.66.9.32.
The importance of outer retinal microstructure, specifically the external limiting membrane (ELM) and ellipsoid zone (EZ), was recently highlighted for visual recovery after rhegmatogenous retinal detachment (RRD). Quantitative assessment of the EZ/ELM reflectivity, termed the relative EZ reflectivity (rEZR), is a novel SD-OCT imaging biomarker for photoreceptor integrity. This study evaluates the rEZR's functional relevance after anatomically successful RRD repair, as well as its association with the surgical techniques.
Patients with primary RRD, treated at the Department of Ophthalmology, University of Bonn/Germany between April 2021 and April 2023 and presenting to the six-week postoperative review with complete retinal reattachment, were identified. The rEZR (arbitrary units [AU]) was determined in the postoperative imaging data. Linear-mixed effect models, corrected for patient's age and preoperative macula-on/macula-off RRD situation, were applied to assess the association of the rEZR with the postoperative best-corrected visual acuity (BCVA) and with the previously applied surgical techniques.
A total of 187 patients with a median [interquartile range (IQR)] age of 70.0 [9.7] years (32.1% female) were included. Out of those, 91.4% (n = 171) underwent vitrectomy and 8.6% scleral buckling. Higher rEZR values were significantly associated with a better BCVA (coefficient estimate [CE] = 0.3009 [0.1620; 0.4398], P < 0.001) and scleral buckling (CE = 12.20 [0.33; 24.07], P < 0.044).
This study supports the functional relevance of outer retinal impairment, as quantified by rEZR, and its association with surgery-related variables in the early postoperative period after RRD repair. Further research is needed to better understand the importance of longitudinal rEZR changes to finally achieve the best visual outcomes for RRD patients.
近期研究强调了视网膜外层微观结构，特别是外限制膜（ELM）和椭圆体带（EZ）在孔源性视网膜脱离（RRD）后视觉恢复中的重要性。定量评估EZ/ELM反射率，即相对EZ反射率（rEZR），是一种用于评估光感受器完整性的新型SD-OCT成像生物标志物。本研究评估了解剖复位成功的RRD修复术后rEZR的功能相关性及其与手术技术的关联。
纳入2021年4月至2023年4月在德国波恩大学眼科接受治疗且术后六周复查时视网膜完全复位的原发性RRD患者。在术后成像数据中测定rEZR（任意单位[AU]）。应用校正患者年龄和术前黄斑在位/不在位RRD情况的线性混合效应模型，评估rEZR与术后最佳矫正视力（BCVA）以及先前应用的手术技术之间的关联。
共纳入187例患者，年龄中位数[四分位间距（IQR）]为70.0[9.7]岁（女性占32.1%）。其中，91.4%（n = 171）接受了玻璃体切除术，8.6%接受了巩膜扣带术。较高的rEZR值与较好的BCVA（系数估计值[CE]=0.3009[0.1620；0.4398]，P<0.001）和巩膜扣带术（CE = 12.20[0.33；24.07]，P<0.044）显著相关。
本研究支持通过rEZR量化的视网膜外层损伤的功能相关性及其与RRD修复术后早期手术相关变量的关联。需要进一步研究以更好地理解rEZR纵向变化的重要性，最终为RRD患者实现最佳视觉效果。
