Infrared imaging of the morphological stages of rhegmatogenous retinal detachment

Purpose of this study is to investigate the features of infrared (IR) imaging in rhegmatogenous retinal detachment (RRD) depending on the morphological stages of changes in the outer layers of the retina.

Material and methods. The study included 60 patients (60 eyes) with primary dysregulated, progressive RRD (32 women and 28 men; mean age 46.7 ± 13.3 years). Before surgery all patients underwent a standard ophthalmological examination. As an additional diagnostic method, a study was performed on a Mirante device (Nidek, Japan) with parallel registration of IR images and structural optical coherence tomography (OCT) scans that record the stage-by-stage changes in the neuroepithelium during RRD. OCT scans were performed from the area of the tear to the boundaries of the retinal detachment, with each stage being determined. The obtained OCT data were then compared with the IR images.

Results. IR-imaging was used to describe sequential morphological changes in the outer retinal layers in dysregulated RRD. In IR light, the stages of RRD are characterized by: stages 1–2 — they had no distinguishing features among themselves and were visualized as a hyporeflective area, less expressed than in stages 3 and 4; stage 3 — a hyporeflective background with different heights and amplitudes, randomly arranged, clearly outlined hyperreflective folds; stage 4 — expressed hyperreflectivity without visible folds; stage 5a — a spotted pattern (“moth-eaten retina”) on a hyperreflective background, alternating hypo — (thickened photoreceptors) and hyperreflective (loss of photoreceptors) zones. Stage 5b is an expressed hyperrefletive zone with distinct boundaries.

Conclusions. IR-imaging revealed characteristic diagnostic signs of stage morphological changes of neuroepithelium after RRD, correlated with the OCT. The obtained results confirm the clinical significance of IR ophthalmoscopy in assessing structural changes of the retina, expanding the diagnostic capabilities of IR-imaging in the diagnosis and monitoring of patients with RRD.

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