Kreissig Lecture Preview: Retinal Mobility and Plasticity in Retinal Surgery

Professor Hiroko Terasaki will deliver the Kreissig Award Lecture in Hall 1 (Level 2) at 12:30 on Saturday 3 September 2022. Lecture highlights key questions about retinal mobility and plasticity.

The ways in which recent advances in imaging technologies have helped to enhance our understanding of fundamental questions concerning retinal mobility and plasticity in retinal surgery will be the main focus of this year’s Kreissig Lecture by Hiroko Terasaki MD, PhD.

“My talk will focus on three key points: first, how much macular cone function is recovered after treatment for rhegmatogenous retinal detachment (RRD), second, I will discuss choroidal circulation after segmental buckling and then finish off my talk with some observations about retinal mobility and how it contributes to functional recovery in macular hole surgery,” said Prof Terasaki, Professor at Nagoya University Institutes of Innovation for Future Society, Japan.

Prof Terasaki will outline her research showing postoperative recovery of cone function from RRD using focal macular electroretinography (FERG) and imaging techniques such as optical coherence tomography (OCT) and adaptive optics.

“Our studies showed that macular cone function evaluated from FERG has recovered by about 70% at one year after RD surgery, and outer segment marker measured by OCT was significantly correlated with this functional recovery. Furthermore, we demonstrated that the growing cone outer segment, as evaluated in ellipsoid zone-retinal pigment epithelium (EZ-RPE) thickness measurements, was related to the increasing visual acuity,” she said.

The studies also showed that mean cone density at 2-degrees from the fovea had reached approximately 60% of the fellow eye and the recovery continued until at least 12 months.

“Increased cone density was significantly related to the cone interdigitation zone (CIZ)-RPE thickness. The key point is that interventions applied to the growing photoreceptor outer segment must be targeted to enable good recovery of macular function,” she said.

Prof Terasaki will also highlight her research relating to submacular fluid in scleral buckling surgery.

“Persistent submacular fluid has been reported to be more frequently seen in buckling surgery but there are contradictory reports on whether it influences the visual outcome. Our analysis suggests that delayed absorption, which is defined at one month on OCT, was not an influence on the final visual acuity at 12 months. Furthermore, the mean best-corrected visual acuity was significantly better in eyes with foveal bulge throughout the postoperative course,” she said.

In terms of choroidal circulation after buckling, Prof Terasaki will explain how she used laser speckle flowgraphy (LSFG) to analyse retinal blood flow on the disc, and choroidal blood flow at the macula and other locations.

“In our series of 46 eyes after segmental buckling, macular choroidal blood flow was not changed through 12 weeks. On the other hand, there was a significant reduction in choroidal blood flow at the buckle side at 8 weeks after surgery. Because decreased blood flow was delayed and mostly on the buckle side, it may be caused by the local chorioretinal atrophy after cryopexy but not by the compression force of scleral buckle itself,” she said.

Prof Terasaki will conclude her talk by addressing the question of if and how retinal mobility contributes to better morphological reconstruction and functional recovery after macular hole surgery.

Professor Hiroko Terasaki will deliver the Kreissig Award Lecture in Hall 1 (Level 2) at 12:30 on Saturday 3 September 2022.