Graduate Student Seminar Series – Reut Shor
Graduate Student Seminar Series
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Location: MS2158 – 1 King’s College Circle
Presentation Title: Reversing Outer Retinal Corrugations: Toward Optimized RRD Management
Abstract:
Objective: To develop and validate a quantitative biomechanical framework that models outer retinal corrugations (ORC) formation and progression in rhegmatogenous retinal detachment (RRD) patients, to predict the development of post-op outer retinal fold (ORF).
Methods: In a prospective, multicenter cohort at St. Michael’s Hospital (Toronto, Canada) and the Department of Medicine and Health Sciences “V. Tiberio” (Campobasso, Italy) from January 1, 2023, to January 1, 2025, sequential OCT scans of detached retinas in RRD patients were obtained at presentation, within 24h before treatment, and at 1-, 3-, and 6-months post-treatment. Regions of interest (ROIs) were aligned across scans using shared anatomic landmarks, manually segmented, and automatically analyzed in MATLAB to compute strain mismatch and elasticity-modulus mismatch. Measured values were compared with theoretical predictions for surface-instability patterns in a bilayer system with differential expansion rates. Temporal changes in strain and modulus mismatch were evaluated against kinetic models of gel swelling. Correlation between strain values, post-op ORF development and visual acuity (VA) were tested.
Results: 42 patients (60 ROIs) met inclusion criteria. Post-op ORF occurred in 13/60 ROIs (21.7%). Elasticity-modulus mismatch versus strain was mapped to a bilayer phase diagram within a high-adhesion regime, with non-corrugated ROIs in the “flat” region and corrugated ROIs in the “wrinkle/fold” domains. The minimum strain for the flat-to-corrugated transition was 0.13. No ORFs were observed for strain 5. The strain threshold associated with ~50% ORF risk differed by treatment: ≥0.25 for Pars Plana Vitrectomy (PPV) or Scleral Buckle (SB) and ≥0.43 for Pneumatic Retinopexy (PnR). A kinetic model of ORC progression based on gel-swelling theory showed good agreement with the data. Across cohorts, higher pre-op strain trended toward worse post-op VA.
Conclusions: ORC behavior in RRD can be quantitatively characterized by strain and elasticity-modulus mismatch. Treatment-dependent strain thresholds predict post-op ORF and align with observed visual acuity trends. This mechanics-based framework elucidates ORC pathophysiology and may support risk stratification in choosing timing and selection of reattachment strategies.
Supervisor Name: Prof Frank Gu, Dr Rajeev Muni
Year of Study: 2
Program of Study: MASc
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