Quantification of cone loss after macula‐involving retinal detachment using the RTX‐1 Adaptive optics camera

Abstract

AbstractPurpose To image the macular cone photoreceptors in eyes with successful repair of retinal detachment (RD) and in healthy fellow eyes using the RTX‐1 Adaptive optics camera from Imagine Eyes™ and to correlate the results to clinical outcomes.Methods Patients operated for macula‐off RD were imaged 6 weeks after surgery. The images were analyzed using AO Detect v.0.1. Cone density, spacing between cells, and the nearest‐neighbor analysis were measured 1° nasally and temporally from the fovea. Best corrected Visual acuity (BCVA) and thickness of the photoreceptor inner and outer segment junction (IS/OS) line imaged by SD‐OCT were also measured.Results Twenty one patients (42 eyes) were studied. The parafoveal cone density was decreased in eyes operated for RD (mean±SD: 14,576±4035/mm2) compared to fellow eyes (20,589±2350/mm2) (Wilcoxon matched pairs test, p=0.0001). There was also an increase in cone spacing (10.3±2.6 vs. 8.0±1.0.9 μm, p<0.0001). The Voronoï analysis revealed a reduction in the percentage of cones with six neighbors (36.5±4.2 vs. 42.7± 4.6%, p=0.0003). The IS/OS line thickness was correlated to the cone density in the same area (r=0.62, p< 0.0001). BCVA was significantly correlated to cone density and inversely to intercone spacing, and in a lesser proportion to the percentage of cones with six neighbors (r=0.8, −0.71 and 0.49, respectively, p<0.001).Conclusion There was a decrease in the cone density after RD with an estimated loss of one‐third of the cones in comparison with fellow eyes. Visual acuity was highly correlated with the parafoveal cone density and cone spacing. AO may be a valuable prognostic tool after RD surgery.