The Advantages of Multimodal Imaging in the Diagnosis of Rhegmatogenous Retinal Detachment

Purpose : To study the possibilities of a modern multimodal ultra-wide field fundus imaging system based on a confocal scanning laser ophthalmoscope (cSLO) in the pre- and postoperative examination of patients with rhegmatogenous retinal detachment (RRD). Patients and methods . 20 patients (20 eyes) with RRD aged 45.4 ± 14.8 years (12 women and 8 men) who underwent local scleral buckling were examined. As part of the preoperative examination, all patients underwent a standard ophthalmological examination (including an examination of the fundus with a Goldmann three mirror lens and a 78D lens). As an additional diagnostic method, a study was performed on a Mirante device (Nidek, Japan) before and 3 days after local scleral buckling. We compared the number of patients with RRD who had primary breaks and zones of rhegmatogenous peripheral degenerations detected using standard preoperative ophthalmoscopy and imaging in various diagnostic modes on a multimodal ultra-wide field cSLO platform (color image cSLO, infrared imaging, retro-mode, optical coherence tomography (OCT) of the macular area and the periphery of the retina). Result . cSLO imaging in various diagnostic modes revealed a primary retinal break in all 20 patients (100 %) with RRD, including three patients whose breaks were not detected during a standard preoperative fundus examination with a Goldmann three mirror lens and a 78D lens. The multimodal approach made it possible to document the initial retinal status, the boundaries of the detached retina, the localization of the breaks and the zones of the rhegmatogenous peripheral degenerations. In the postoperative period, ultra-wide field imaging in combination with peripheral OCT made it possible to objectively document the attachment of the retina, the blocking of breaks and areas of rhegmatogenous degeneration by through external scleral indentation. Conclusions . The use of the multimodal opportunities of the ultra-wide field diagnostic system has shown high informativity in the examination of patients with RRD, makes it possible to accurately identify and document the boundaries of RRD, retinal breaks, their morphometric features, as well as other features of the patient’s retinal status, and to conduct detailed monitoring of the anatomical success of surgery after surgery.