Bacillary layer detachment: Updates on its clinical and prognostic significance in retinal disease

Alessandro Feo; Elisa Stradiotto; Andrea Govetto; Paolo Forte; Giacomo Boscia; Massimo Nicolò; Jennifer Cattaneo; Chiara M Eandi; Martina Angi; Prithvi Ramtohul; Mario R Romano

doi:10.1016/j.survophthal.2025.01.005

Bacillary layer detachment: Updates on its clinical and prognostic significance in retinal disease

Surv Ophthalmol. 2025 Jan 14:S0039-6257(25)00013-X. doi: 10.1016/j.survophthal.2025.01.005. Online ahead of print.

Authors

Affiliations

¹ Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele-Milan, Italy. Electronic address: [email protected].
² Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele-Milan, Italy.
³ Department of Ophthalmology, Eye Unit Humanitas Gavazzeni-Castelli, via Mazzini 11, Bergamo, Italy.
⁴ Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Department of Ophthalmology, University of Lausanne, Switzerland; IRCCS Ospedale Policlinico San Martino, Eye Unit, Genoa, Italy; DINOGMI, University of Genoa, Italy.
⁵ Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", 70121 Bari, Italy.
⁶ IRCCS Ospedale Policlinico San Martino, Eye Unit, Genoa, Italy; DINOGMI, University of Genoa, Italy.
⁷ Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Department of Ophthalmology, University of Lausanne, Switzerland.
⁸ Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Department of Ophthalmology, University of Lausanne, Switzerland; Department of Surgical Sciences, University of Torino, Torino, Italy.
⁹ Ocular Oncology Service, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
¹⁰ Department of Ophthalmology, Hospital Nord, Aix-Marseille University, Chemin des Bourrely, Marseille, France.
¹¹ Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele-Milan, Italy; Department of Ophthalmology, Eye Unit Humanitas Gavazzeni-Castelli, via Mazzini 11, Bergamo, Italy.

PMID: 39818360
DOI: 10.1016/j.survophthal.2025.01.005

Abstract

Bacillary layer detachment (BALAD) refers to the distinctive splitting at the level of the photoreceptor inner segment myoid and accumulation of intraretinal fluid, as seen on optical coherence tomography (OCT).BALAD is an increasingly recognized OCT biomarker of numerous heterogeneous chorioretinal diseases, including posterior uveitis, age-related macular degeneration and macular neovascularization, neoplastic and paraneoplastic retinal disorders, rhegmatogenous retinal detachment, blunt ocular trauma, and miscellaneous conditions. The recognition of BALAD is clinically relevant because, based on the specific etiology, BALAD may require simple observation, ocular or systemic medical treatment, or even surgical intervention, with subsequent different prognosis. In our review, we discuss and summarize the clinical and prognostic significance of BALAD in the different chorioretinal disorders in which it has been described.

Keywords: BALAD; Bacillary layer detachment; clinical significance; prognosis.

Publication types

Review