Objective method to recognize warning signs in peripheral vitreoretinal dystrophies

Abstract

to compare the effectiveness of biomicroscopy (BMS) and optical coherence tomography (OCT) in recognizing prognostically unfavorable signs in peripheral vitreoretinal dystrophy (PVRD) patients. A total of 131 cases of equatorial PVRD (91 eyes of 56 patients) were assessed. The mean patient's age was 24.7 years. The length of the anterior-posterior axis of the eyeball averaged 25.36±1.12 mm. Prevalence of particular warning signs in PVRD patients at BMS or OCT was comparatively analyzed. In 46 eyes with lattice dystrophy it was difficult to determine the presence of vitreoretinal traction at BMS; at OCT, areas of retinal adhesion to the posterior hyaloid membrane (PHM) along the edges of PVRD zones were revealed in all eyes. Of 31 eyes with «snail tracks» defects of the retina, 6 were diagnosed at BMS; in OCT scans of these patients, the PHM appeared firmly fixed along the edges of PVRD zones in all cases. As to horseshoe retinal tears (valve-like tears), BMS allowed to visualize vitreoretinal tractions in 7 of 12 eyes, while OCT revealed a tight contact between the PHM and the apex of the retinal flap in 11 of 12 eyes. In 7 eyes with retinoschisis we failed to detect any retinal traction at either BMS or OCT. In «non-differentiable» PVRD, BMS was also not able to reveal any vitreoretinal traction, while OCT was - in all 12 cases. OCT has proved much more effective than BMS in recognizing prognostically unfavorable signs in particular clinical forms of PVRD, such as vitreoretinal tractions, retinal defects, and intraretinal cavities.