Preoperative estimation of retinal hole location using ultra-wide-field imaging

Abstract

Background/Objective

Accurate localization of retinal holes is essential for successful scleral buckling (SB) surgery. We aimed to verify the feasibility of using ultra-wide-field (UWF) imaging for preoperative estimation of retinal hole location.

Patients and Methods

We observed 21 eyes from 21 patients with rhegmatogenous retinal detachment (RRD) who underwent successful SB. They were treated at the Department of Ophthalmology of the Second Hospital of Hebei Medical University between November 2020 and November 2021. UWF fundus photography using an Optos device was performed at different steering positions 1 day before, 1 day after, and 1 month after SB. Using the preoperative fundus images, we measured the transverse diameter of the optic disc (D1) and the distance from the centre of the retinal holes to the ora serrata (D2). The accurate transverse diameter of the optic disc (Dd) was measured preoperatively using optical coherence tomography. The same surgeon measured the scleral chord lengths intraoperatively from the limbus to the located retinal hole marked on the sclera using an ophthalmic calliper. Statistical software was used to analyze the consistency of scleral chord length between the retinal hole and the limbus, which was estimated by preoperative UWF imaging and was measured using an ophthalmic calliper intraoperatively.

Results

There was no statistically significant difference in the scleral chord length between the retinal holes and the limbus, which was estimated by preoperative UWF fundus photography and was measured by the calliper during surgery.

Conclusion

It is feasible to locate retinal holes using UWF fundus photography before SB, which is helpful for quick localization, thereby reducing the learning curve of SB surgery.

KEY MESSAGES:

1. Preoperative ultra-wide-field imaging can provide abundant information about retinal holes and is helpful for assessing their location before surgery.

2. In this prospective cohort study of 21 patients, 25 retinal holes in four quadrants were observed.

3. Axial length and the position of the holes have little impact on preoperative ultra-wide field imaging assessment.

Keywords:

• Ultra-wide-field imaging
• rhegmatogenous retinal detachment
• scleral buckling
• retinal hole

Acknowledgements

We appreciate the skilful assistance of physicians and nurses at the Department of Ophthalmology, the Second Hospital of Hebei Medical University.

Ethical approval

The study was approved by the Ethical Committee of the Affiliated Second Hospital of Hebei Medical University, and all investigations adhered to the tenets of the Declaration of Helsinki. Written informed consent was obtained from the patients enrolled in the study.

Authors’ contributions

Qingli Shang and Jialiang Duan designed and directed the study. Donghui Li, Nalei Zhou, and Rui Gao collected and analyzed the data and edited the manuscript. All authors discussed the results and commented on the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

All data supporting the findings of this study are available from the corresponding author upon request.

Additional information

Funding

This study was supported by the Natural Science Foundation of Hebei Province, under grant numbers H2020206063 and H2019206306.