The Usefulness of Optical Coherence Tomography in Macula-off Retinal Detachment

PURPOSE: To report the usefulness of optical coherence tomography (OCT) for assessing postoperative visual acuity in macula-off retinal detachment. METHODS: This prospective study included 54 patients who were operated on for macula-off retinal detachment, and who could be followed up for at least 6 months, between September 2003 and July 2005. Patients were examined at 1 day before surgery and at 1, 3, and 6 months after surgery for best corrected visual acuity, intraocular pressure, by slit lamp examination, fundus examination, and OCT. RESULTS: Preoperative best corrected visual acuities improved at 1, 3, and 6 months after surgery (p<0.05). The average period of macular reattachment with fundus examination was found to be 24 days, but with OCT it was found to be 52 days. Improvement of best corrected visual acuity was found in 40 eyes (74.1%), and among these, reattachment of the macula on OCT was found in 36 eyes (90%). Postoperative visual acuity was better when there was better preoperative visual acuity, a shorter duration of macular detachment, and when the height of the detached macula on OCT was shorter. CONCLUSIONS: Macular reattachment as determined by OCT was related to the improvement of visual acuity after surgery. We suggest that OCT is useful in patients whose macular reattachment was seen on fundus examination but whose postoperative visual acuity had not improved.

Anterior Lens Capsule Abnormalities in Alport Syndrome

Alport syndrome is a hereditary, progressive disease characterized by progressive nephritis, sensorineural deafness, and ocular abnormalities, including anterior lenticonus. The ultrastructure of the lens capsule abnormalities in Alport syndrome is reported. Four anterior lens capsules from 31-year-old patient and 26-year-old patient with lenticonus who were affected by the Alport syndrome were obtained at capsulectomy. And all four anterior lens capsules were examined by transmission electron microscopy. The histopathologic findings showed that the thickness of the anterior lens capsules was decreased (4~13 micrometer) and that there were many vascular dehiscences localized at the inner part of the lens capsule. There were large numbers of capsular dehiscences containing fibrillar materials and vacuoles. The anterior capsules were clearly fragile in this disease, forming the basis for the progressive lenticonus and anterior polar cataract.