Melanin-related near-infrared fundus autofluorescence combined with optical coherence tomography for studying macular structure changes in the early stages after undergoing scleral buckling for rhegmatogenous retinal detachment
Objective To evaluate the changes in macular structure in the early stages after undergoing scleral buckling surgery for rhegmatogenous retinal detachment （RRD）； to use melanin-related near-infrared fundus autofluorescence （NIA） combined with optical coherence tomography （OCT） for studing the changes. Methods This was a prospective case-series study. Melanin-related near-infrared fundus autofluorescence （NIA） and optical coherence tomography （OCT） examinations were performed on 21 patients with local primary RRD three months after undergoing a successful scleral buckling procedure for retinal reattachment. The RRDs in all 21 eyes involved the macula. To check the anomalies fo the images and the recovery of the vision after surgery. Changes invision after surgery were compared with a paired t test. The correlation of NIA and BCVA was analyzed with the relevance of two-way disorderly classification variable data. Results NIA revealed that 16 eyes had hypofluorescence surrounded by hyperfluorescence and 5 eyes had uneven hyperfluorescence. Submacular fluid was found in 20 eyes. The retinal nerve fiber layer in the central fovea became thinner in 6 eyes. In one eye， the retinal nerve fiber layer in the central fovea became thicker， and in another 14 eyes the thickness of the retinal nerve fiber layer was normal. The reflection from the photoreceptor inner and outer segment junction （IS/OS） was abnormal in all 21 eyes. Visual acuity measured with NIA revealed that the hypofluorescence which was surrounded by hyperfluorescence had improved at the 3-month follow-up compared to the 1-day follow-up examination （t=9.922， P<0.05）， while VA measured at the same time revealed that uneven hyperfluorescence had not improved at the 3-month follow-up （t=2.409， P>0.05）. The macular NIA results and the change in postoperative BCVA were highly correlated （r=0.502， P<0.05）. Conclusion Macular function and structure do not fully recover in the early stages after undergoing scleral buckling to treat RRD. More attention should be paid to this problem.
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