Quantification of cone loss after macula-involving retinal detachment using the RTX-1 Adaptive optics camera

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To image the macular cone photoreceptors in eyes with successful repair of retinal detachment (RD) and in healthy fellow eyes using the RTX-1 Adaptive optics camera from Imagine Eyes™ and to correlate the results to clinical outcomes.


Patients operated for macula-off RD were imaged 6 weeks after surgery. The images were analyzed using AO Detect v.0.1. Cone density, spacing between cells, and the nearest-neighbor analysis were measured 1° nasally and temporally from the fovea. Best corrected Visual acuity (BCVA) and thickness of the photoreceptor inner and outer segment junction (IS/OS) line imaged by SD-OCT were also measured.


Twenty one patients (42 eyes) were studied. The parafoveal cone density was decreased in eyes operated for RD (mean±SD: 14,576±4035/mm2) compared to fellow eyes (20,589±2350/mm2) (Wilcoxon matched pairs test, p=0.0001). There was also an increase in cone spacing (10.3±2.6 vs. 8.0±1.0.9 μm, p<0.0001). The Voronoï analysis revealed a reduction in the percentage of cones with six neighbors (36.5±4.2 vs. 42.7± 4.6%, p=0.0003). The IS/OS line thickness was correlated to the cone density in the same area (r=0.62, p< 0.0001). BCVA was significantly correlated to cone density and inversely to intercone spacing, and in a lesser proportion to the percentage of cones with six neighbors (r=0.8, −0.71 and 0.49, respectively, p<0.001).


There was a decrease in the cone density after RD with an estimated loss of one-third of the cones in comparison with fellow eyes. Visual acuity was highly correlated with the parafoveal cone density and cone spacing. AO may be a valuable prognostic tool after RD surgery.

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