Imaging rhegmatogenous retinal lesions and peripheral vitreo-retinal interface with wide-field optical coherence tomography

Analyze the peripheral vitreo-retinal interface with widefield optical coherence tomography (WF-OCT).Retrospective chart analysis and WF-OCT in 120 consecutive cases of rhegmatogenous pathology.There were 166 lesions in 120 eyes, including 106 horseshoe tears, 22 operculated (OH), 30 non-operculated (NOH) holes, 6 giant tears, and 2 peripheral lamellar defects followed for 6.1±1.2 months. Posterior vitreous detachment was present in all eyes (101/101, 100%) with tears and OHs, but only in 5/19 eyes (26.3%) with NOHs (p<0.001). Axial vitreous traction was evident at the anterior edge of horseshoe tears (106/106, 100%), but not the posterior border (18/106, 17%, p<0.001). OHs located posterior to the vitreous base were free from vitreous traction, displaying a morphology similar to macular hole. NOHs were farther anterior with signs of tangential traction in 23/30 (76.7%) cases. Peripheral vitreoschisis was more often associated with NOHs (25/30, 83.3%), than horseshoe tears (17/106, 16%; p<0.001). Horseshoe tears and NOHs were more often associated with retinal detachment (58/106 (54.7%) and 15/30 (50%), respectively) than OHs (5/22, 22.7%), p=0.023.Peripheral vitreo-retinal interactions are similar to vitreo-maculopathies, with axial and vitreoschisis-related tangential traction playing different roles in different rhegmatogenous pathologies. Peripheral OCT improves understanding of pathophysiology and risks of retinal detachment.