Abstract
Purpose
To evaluate the correlation between foveal changes in the detached retina in macula-off rhegmatogenous retinal detachments (RRD) and visual acuity outcome following repair.
Design
Retrospective, consecutive, observational case series.
Methods
Consecutive patients presenting with macula-off RRD between July 15 and September 15, 2017, underwent SD-OCT imaging and their medical records were reviewed. Specific OCT exam parameters were used to evaluate the fovea of the detached retina.
Results
In total, 47 patients with macula-off RRD were treated from July 15 to September 15, 2017. Forty-four eyes of 44 patients could be imaged by SD-OCT and were included in the analysis. Univariate analysis demonstrated a correlation between the height of the detachment, the duration of symptoms, the presence of macular hole and epiretinal membrane to the final VA. Correlation was also found between the presence of MH and the height of the detachment. However, multiple regression analysis demonstrated only a statistically significant correlation between the presence of a macular hole or an epiretinal membrane to the final VA.
Conclusions
Our study is the first to demonstrate the significance of foveal changes in the pathogenesis of lost vision in macula-off retinal detachments. The high rate of macular holes and the correlation between the MH and the height of the detachment suggest that elevated tension in the fovea in high detachments might play a significant role in the visual outcome of macula-off RRD following repair.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Schwartz SG, Flynn HW, Mieler WF. Update on retinal detachment surgery. Curr Opin Ophthalmol. 2013;24:255–61. https://doi.org/10.1097/ICU.0b013e32835f8e6b
Gerding H, Hersener A. Anatomical and functional results of primary pars plana vitrectomy in rhegmatogenous retinal detachment. Klin Monbl Augenheilkd. 2013;230:409–12. https://doi.org/10.1055/s-0032-1328392
Schmidt JC, Rodrigues EB, Hoerle S, Meyer CH, Kroll P. Primary vitrectomy in complicated rhegmatogenous retinal detachment–a survey of 205 eyes. Ophthalmologica. 2003;217:387–92. https://doi.org/10.1159/000073067
Nakanishi H, Hangai M, Unoki N, Sakamoto A, Tsujikawa A, Kita M, et al. Spectral-domain optical coherence tomography imaging of the detached macula in rhegmatogenous retinal detachment. Retina. 2009;29:232–42. https://doi.org/10.1097/IAE.0b013e31818bcd30
Kim JD, Pham HH, Lai MM, Josephson JW, Minarcik JR, Von, Fricken M. Effect of symptom duration on outcomes following vitrectomy repair of primary macula-off retinal detachments. Retina. 2013;33:1931–7. https://doi.org/10.1097/IAE.0b013e3182877a27
Karacorlu M, Sayman Muslubas I, Hocaoglu M, Arf S, Ersoz MG. Correlation between morphological changes and functional outcomes of recent-onset macula-off rhegmatogenous retinal detachment: prognostic factors in rhegmatogenous retinal detachment. Int Ophthalmol. 2018;38:1275–83. https://doi.org/10.1007/s10792-017-0591-6
Park DH, Choi KS, Sun HJ, Lee SJ. Factors associated with visual outcome after macula-off rhegmatogenous retinal detachment surgery. Retina. 2018;38:137–47. https://doi.org/10.1097/IAE.0000000000001512
Mowatt L, Shun-Shin GA, Arora S, Price N. Macula off retinal detachments. How long can they wait before it is too late? Eur J Ophthalmol. 2018;15:109–17. http://www.ncbi.nlm.nih.gov/pubmed/15751248 Accessed December 6
Lecleire-Collet A, Muraine M, Menard J-F, Brasseur G. Predictive visual outcome after macula-off retinal detachment surgery using optical coherence tomography. Retina. 2005;25:44–53. http://www.ncbi.nlm.nih.gov/pubmed/15655440 Accessed December 6, 2018
Ross W, Lavina A, Russell M, Maberley D. The correlation between height of macular detachment and visual outcome in macula-off retinal detachments of ≤7 days’ duration. Ophthalmology. 2005;112:1213–7. https://doi.org/10.1016/j.ophtha.2005.01.040
Kang HM, Lee SC, Lee CS. Association of spectral-domain optical coherence tomography findings with visual outcome of macula-off rhegmatogenous retinal detachment surgery. Ophthalmologica. 2015;234:83–90. https://doi.org/10.1159/000381786
Theodossiadis PG, Theodossiadis GP, Charonis A, Emfietzoglou I, Grigoropoulos VG, Liarakos VS. The photoreceptor layer as a prognostic factor for visual acuity in the secondary epiretinal membrane after retinal detachment surgery: imaging analysis by spectral-domain optical coherence tomography. Am J Ophthalmol. 2011;151:973–80. https://doi.org/10.1016/j.ajo.2010.12.014
Gharbiya M, Grandinetti F, Scavella V, Cecere M, Esposito M, Segnalini A et al. Correlation between spectral-domain optical coherence tomography findings and visual outcome after primary rhegmatogenous retinal detachment repair. Retina. 2012;32:43–53. https://doi.org/10.1097/IAE.0b013e3182180114
Cho M, Witmer MT, Favarone G, Chan RP, D’Amico DJ, Kiss S. Optical coherence tomography predicts visual outcome in macula-involving rhegmatogenous retinal detachment. Clin Ophthalmol. 2012;6:91–6. https://doi.org/10.2147/OPTH.S28173
Sayman Muslubas I, Hocaoglu M, Ersoz MG, Arf S, Karacorlu M. Choroidal thickness in chronic rhegmatogenous retinal detachment before and after surgery, and comparison with acute cases. Int Ophthalmol. 2018;38:1035–42. https://doi.org/10.1007/s10792-017-0556-9
Delolme MP, Dugas B, Nicot F, Muselier A, Bron AM, Creuzot-Garcher C. Anatomical and functional macular changes after rhegmatogenous retinal detachment with macula off. Am J Ophthalmol. 2012;153:128–36. https://doi.org/10.1016/j.ajo.2011.06.010
Hagimura N, Suto K, Iida T, Kishi S. Optical coherence tomography of the neurosensory retina in rhegmatogenous retinal detachment. Am J Ophthalmol. 2000;129:186–90. http://www.ncbi.nlm.nih.gov/pubmed/10682971 Accessed December 6, 2018
Smith AJ, Telander DG, Zawadzski RJ, Choi SS, Morse LS, Werner JS, et al. High-resolution fourier-domain optical coherence tomography and microperimetric findings after macula-off retinal detachment repair. Ophthalmology. 2008;115:1923–9.
Wolfensberger TJ, Gonvers M. Optical coherence tomography in the evaluation of incomplete visual acuity recovery after macula-off retinal detachments. Graefes Arch Clin Exp Ophthalmol. 2002;240:85–9. http://www.ncbi.nlm.nih.gov/pubmed/11931084 Accessed December 6, 2018
Guérin CJ, Lewis GP, Fisher SK, Anderson DH. Recovery of photoreceptor outer segment length and analysis of membrane assembly rates in regenerating primate photoreceptor outer segments. Invest Ophthalmol Vis Sci. 1993;34:175–83. http://www.ncbi.nlm.nih.gov/pubmed/8425823 Accessed December 6, 2018
Duker JS, Kaiser PK, Binder S, de Smet MD, Gaudric A, Reichel E, et al. The international vitreomacular traction study group classification of vitreomacular adhesion, traction, and macular hole. Ophthalmology. 2013;120:2611–9. https://doi.org/10.1016/j.ophtha.2013.07.042
Yanagiya N, Akiba J, Takahashi M, Shimizu A, Kakehashi A, Kado M, et al. Clinical characteristics of traumatic macular holes. Jpn J Ophthalmol. 1996;40:544–7.
Johnson RN, McDonald HR, Lewis H, Grand MG, Murray TG, Mieler WF, et al. Traumatic macular hole: observations, pathogenesis, and results of vitrectomy surgery. Ophthalmology. 2001;108:853–7. https://doi.org/10.1016/S0161-6420(00)00650-3
Author information
Authors and Affiliations
Contributions
AH was responsible for designing the protocol, writing the protocol and report, conducting the statistics, extracting and analysing data, interpreting results and summary the finding. RT contributed to writing the report, extracting and analysing data and interpreting results. AA contributed to extracting and analysing data, interpreting results and writing the protocol. PK and KE contributed to designing the protocol.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Hostovsky, A., Trussart, R., AlAli, A. et al. Pre-operative optical coherence tomography findings in macula-off retinal detachments and visual outcome. Eye 35, 3285–3291 (2021). https://doi.org/10.1038/s41433-021-01399-z
Received:
Revised:
Accepted:
Published:
Version of record:
Issue date:
DOI: https://doi.org/10.1038/s41433-021-01399-z
This article is cited by
-
Grading retinal displacement after retinal detachment repair: a prospective study linking displacement grade and visual outcome
Graefe's Archive for Clinical and Experimental Ophthalmology (2025)
-
Impact of duration of silicone oil tamponade on foveal and parafoveal thickness in rhegmatogenous retinal detachment: a retrospective cohort study
International Ophthalmology (2024)
-
The prognostic implication of visual acuity at the time of uveal melanoma diagnosis
Eye (2023)
-
How should we report the foveal status in eyes with “macula-off” retinal detachment?
Eye (2023)
-
A mathematical determination of foveal attachment in primary rhegmatogenous retinal detachment when obscured by bullous retina
International Journal of Retina and Vitreous (2022)


