About the research topic
Retinal detachment is a common eye condition: the incidence in the Netherlands is estimated at 2.6 per 10,000 inhabitants and is still increasing. In a retinal detachment, fluid enters the subretinal space through a peripheral retinal tear. As soon as the fluid gets under the macula, vision suddenly drops. One speaks of “split fovea” when, prior to the operation, part of the macula is “detached” and the other part is not. It is known that patients of retinal detachment have a drop of cones in the macula, with the number being 31-63% lower after surgery. It is striking that the cone density is also lower when the macula was still attached before the operation. A possible explanation is that the photoreceptors were temporarily changed by the surgery or by retinal damage in the periphery.
Adaptive optics flood illumination ophthalmoscopy (AO-FIO) has recently become available for clinical use. It has a good lateral resolution (down to two microns), which allows individual photoreceptors to be visualized. This allows more insight into the dynamics of the photoreceptors. However, since the imaging modality is so sensitive, a challenge is to determine which patients are suitable for AO-FIO and what is the optimal protocol for imaging.
The aim of the current pilot study is to demonstrate in 20 patients that cone density can be accurately and reliably measured after vitrectomy in retinal detachment patients. If this initial study proves successful, a larger study can be set up, with the aim of providing more insight into 1) what happens to the photoreceptors after the fovea has (partially) been loosened, 2) the recovery of the photoreceptors in the postoperative period and the correlation with visual function and the layers of the outer part of the retina on optical coherence tomography (OCT), and 3) the role of early surgery for preservation of photoreceptors in this patients.
Funding: Stichting Wetenschappelijk Onderzoek Oogziekenhuis
