Assessment of Proliferative Vitreoretinopathy in Rhegmatogenous Retinal Detachment with OCT
Notice bibliographique
Résumé
PURPOSE: To characterize proliferative vitreoretinopathy (PVR) with swept-source OCT (SS-OCT) in rhegmatogenous retinal detachment (RRD). DESIGN: Prospective cross sectional cohort study. SUBJECTS: Consecutive primary RRDs presenting to St. Michael's Hospital from 2021 to 2023. METHODS: Ultra-widefield fundus imaging was staged per the Retina Society 1991 PVR Classification and correlated with retinal microstructural changes assessed with SS-OCT. MAIN OUTCOME MEASURES: Swept-source OCT findings in PVR. RESULTS: One hundred patients were included. Patients with no signs of PVR or PVR A (49/100) were more likely to have a preserved bacillary layer on SS-OCT with low-amplitude outer retinal corrugations (ORCs) compared with the PVR B/C group. Proliferative vitreoretinopathy B (retinal wrinkling/vessel tortuosity) was present in 24% (24/100) of cases, all of which had high-amplitude ORCs. Proliferative vitreoretinopathy C (27/100) was clinically divided into patients with subretinal (SR) membranes (63% [17/27]) and patients with fixed retinal folds (intraretinal [IR]) (37% [10/27]). The SR subtype was associated with slowly progressive detachments. On SS-OCT, they had a thick hyperreflective membrane emanating from the retinal pigment epithelium and extending along the outer retinal surface, causing tractional folds of the outer retina in 47% (8/17) of cases and tractional bacillary layer detachment in 12% (2/17) of cases. Outer retinal thinning/atrophy was commonly observed in the SR subtype. Patients with the IR subtype had rapidly progressive detachments on fundus examination and extensive IR changes on SS-OCT. These had a thickened bacillary layer with high-amplitude ORCs with photoreceptor-photoreceptor apposition within or between individual corrugations (fused ORCs). Significant preretinal membranes with loss of differentiation of the inner and outer retinal lamellae and distortion of underlying ORCs were observed. CONCLUSIONS: Our study demonstrates imaging evidence of varying PVR morphology. The IR subtype occurs in rapidly progressive detachments with intrinsic retinal changes that span from fused and distorted corrugations to retinal thickening, preretinal membranes, and loss of differentiation of retinal lamella. The SR subtype occurs in slowly progressive detachments, where the proliferation is associated with membranes emanating from the retinal pigment epithelium, outer retinal thinning/atrophy, and tractional outer retinal folds. We present a novel OCT classification of primary PVR, which varies based on RRD morphology. Pathological photoreceptor apposition in fused ORCs may be associated with glial proliferation and corresponding IR and preretinal changes. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
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