Utilization of spectral domain optical coherence tomography to identify posterior vitreous detachment in patients with a retinal detachment.

PURPOSE To compare posterior vitreous detachment (PVD) identification rate between clinical examination vs. spectral domain optical coherence tomography (SD-OCT) in patients with retinal detachment (RD). METHODS Data from the Primary Retinal detachment Outcomes (PRO) study was utilized for this retrospective cross-sectional study of 506 patients. SD-OCT scans were reviewed to detect separation of the posterior hyaloid face from the retina and the optic nerve on all 31 raster cuts of a 30 x 30 scan. Statistical analysis was performed to compare SD-OCT identified PVD with PVD identified on slit lamp biomicroscopy. RESULTS There was a significant difference in rate of PVD identification by clinical examination vs. SD-OCT in patients with RD. Clinical exam identified 51.58% of patients with PVD while SD-OCT showed 78.42%. In patients with macula on RD, 61.68% were found to have PVD on clinical examination vs. 83.90% by imaging. SD-OCT identified larger number of PVD in macula off RD patients compared to clinical examination, 46.28% vs 75.43% respectively. There was low agreement between the two methods (Kappa score = 0.137). There was a significant difference in surgical procedure type chosen in those with vs without a PVD. CONCLUSION Knowledge about the posterior hyaloid anatomy is important before undergoing RD repair. SD-OCT can better identify PVD than clinical examination in patients with RD.