Authors: Koby Yaacov Brosh Heshin, Carolina Francisconi, Verena Juncal, Alan Berger, Louis Giavedoni, David Wong, Fill Altomare, Roxane J Hillier, Francesco Sabatino, Mustafa Kadhim, Richard Newsom, Varun Chaudhary, Jenn Qian, Rajeev Muni

Author Disclosure Block: C. Francisconi: None. V. Juncal: None. A. Berger: None. L. Giavedoni: None. D. Wong: None. F. Altomare: None. R. Hillier: None. F. Sabatino: None. M. Kadhim: None. R. Newsom: None. V. Chaudhary: None. J. Qian: None. R. Muni: None.

Purpose: To compare retinal displacement following retinal detachment repair with pneumatic retinopexy (PnR) versus pars plana vitrectomy (PPV). 

Study Design: This retrospective cross-sectional study compared two surgical interventions (PnR and PPV) for post-operative retinal displacement using fundus autofluorescence imaging (FAF). 

Methods: All patients over the age of 18, who had a retinal detachment repair with post-operative FAF imaging performed between September 1, 2017 and September 1, 2018 were included in the study. Exclusion criteria included patients with low quality FAF images or patients with other retinal diseases that could influence the interpretation of the FAF images. The primary outcome was proportion of patients with retinal displacement determined by the presence of retinal vessel printing (RVP) on FAF imaging. The study was approved by the institutional research ethics board. All FAF images were analyzed independently by two masked graders. In cases of disagreement between the two graders, the FAF images were reviewed by both authors together, and if there was no consensus, the difference was adjudicated by a third masked grader. When positive retinal displacement was found, the following parameters were assessed: direction of the displacement, which quadrants were involved in the displacement, presence of macular involvement in the displacement, maximum and minimum displacement values, presence of radial or rotatory displacement and the number of RVP lines seen. 

Results: 156 eyes of 150 patients were included in the study. There were 48 patients who had PPV, 99 who had PnR, and 9 who had combined scleral buckle and vitrectomy (SB+PPV). Overall, the proportion of patients with retinal displacement was 50% for PPV (24/48), 8% for PnR (8/99), and 78% for SB+PPV (7/9). For macula off detachments, the proportion of patients with retinal displacement was 57% (20/35), versus 9% (6/66) versus 80% (4/5) for PPV, PnR and SB+PPV respectively. For macula on detachments the proportions were 30% (4/13) versus 6% (2/33) versus 100% (1/1) for PPV, PnR and SB+PPV respectively. A statistically significant difference in proportion of patients with retinal displacement was found between the PnR and PPV groups (P<0.001). 

Conclusions: The proportion of patients with retinal displacement as measured with RVP on FAF was significantly less in patients undergoing PnR vs PPV. Patients who underwent combined SB+PPV had very high rates of retinal displacement.