Preoperative Positioning and Progression of Fovea-on Retinal Detachments.

Autor:	Alberti M; Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark. Electronic address: markalberti@gmail.com., Ilsby C; Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark., Christensen UC; Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark., Kiilgaard JF; Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark., la Cour M; Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark.
Jazyk:	angličtina
Zdroj:	Ophthalmology. Retina [Ophthalmol Retina] 2024 Feb; Vol. 8 (2), pp. 137-147. Date of Electronic Publication: 2023 Sep 01.
DOI:	10.1016/j.oret.2023.08.016
Abstrakt:	Purpose: To study the relationship between positioning and rhegmatogenous retinal detachment (RRD) progression before surgery in patients with a fovea-on RRD. Design: Prospective, single-cohort study. Subjects: Patients with fovea-on RRD admitted to hospital for bedrest before surgical treatment were recruited. Methods: Primary outcome was the shortest distance from the foveal center to the retinal detachment border on OCT. Secondary outcomes were measured with a head-mounted positioning sensor and included measures of head movement (linear acceleration and angular velocity) as well as measures of positioning regimen compliance. Main Outcome Measures: Distance from the fovea to the retinal detachment border. Results: Overall, 50 patients with fovea-on positioned before RRD repair. One patient (1/50, 2%) progressed from fovea-on to fovea-off. Of the positioning measures, angular velocity demonstrated the strongest correlation with RRD border movement, whereas measures of positioning compliance showed nonsignificant correlation. After defining 3 movement groups: stable, intermediate, and mobile RRDs, we found that a doubling of head movement (angular velocity) correlated with a median RRD border progression of -6 μm/h, -75 μm/h, and -219 μm/h in the 3 groups, respectively. Conclusions: Rhegmatogenous retinal detachment border movement is correlated to angular velocity of the head, whereas compliance with our current positioning regimen does not have a significant impact on RRD border movement. Not all RRDs progress rapidly toward the fovea, but those that do seem to be highly influenced by head movement. For limiting RRD progression, a reduced movement positioning regimen may be superior to our current gravity-based approach. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. (Copyright © 2023 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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