Characteristics of rhegmatogenous retinal detachment and their relationship to visual outcome

Abstract

Aims To examine pre-operative characteristics of rhegmatogenous retinal detachment (RRD) and their relationship to visual acuity (VA) following surgery. Methods Review of prospectively completed electronic database. Baseline characteristics, retinal drawings and outcomes were analysed. Results In all, 847 eyes from 847 patients with a mean age of 62.2 years, 60% males, and 56% right eyes were studied. Mean follow-up was 9.6 months. Preoperative VA correlated with final VA (r 2 ¼ 0.21, Po0.0001). Median postoperative VA was 6/9 (Logmar 0.18, quartiles ¼ 0.0-0.48) and was significantly related to anatomical success: 70.15% achieved 0.18 or better with fully attached retina and primary success, whereas only 8.33% achieved this when the retina was not fully attached at final follow-up (failure) (Po0.0001). Univariate analysis found multiple variables associated with achieving 0.18 postoperative vision, however, multivariate analysis revealed only primary anatomical success with surgery; absence of proliferative vitreo-retinopathy (PVR), betterpresenting VA and fewer quadrants of detachment were associated with a better visual outcome (r 2 ¼ 0.26, Po0.0001). Patients with a clinically attached fovea achieved better vision than patients with a clinically detached fovea, independent of the visual loss duration. With foveal detachment however, postoperative VA was better in patients with 1-3 days of visual loss compared with 4-6 days (P ¼ 0.013). Conclusions Failure of primary surgery, PVR, extensive RRD and poor-presenting VA are risk factors for poorer visual outcome following surgery for RRD. Fovea off RRD at presentation achieved poorer postoperative VA than fovea attached and visual outcome was poorer when there was a longer duration of visual symptoms.

Rate and risk factors for the conversion of fovea-on to fovea-off rhegmatogenous retinal detachment while awaiting surgery

“…Our data suggest that, if this was the case in our unit, it would have only prevented foveal detachment in 4 out of the 10 cases (reducing the rate from 1.1% to 0.6%). Furthermore, all our patients had good visual outcomes, which are comparable to the outcomes following fovea-on retinal detachment repair 3. All these patients had a detached fovea for a very short time, and this may offer a favourable outcome compared with fovea-off detachments of a longer duration 3 9.…”

“…Furthermore, all our patients had good visual outcomes, which are comparable to the outcomes following fovea-on retinal detachment repair 3. All these patients had a detached fovea for a very short time, and this may offer a favourable outcome compared with fovea-off detachments of a longer duration 3 9. However, there may be some visual morbidity in these patients, which has not been measured using visual acuity alone.…”

“…The present group was compared with 847 eyes of 847 patients from this time period, which have been extensively investigated and described elsewhere 1 3. In brief, the group consisted of 509 (60.1%) men and 338 (39.9%) women, 471 (55.6%) right and 376 (44.4%) left eyes, 477 (56.3%) fovea-on RRDs and 360 (43.7%) fovea-off RRDs.…”

Scleral and conjunctival features in patients with rhegmatogenous retinal detachment undergoing scleral buckling: an anterior segment optical coherence tomography and in vivo confocal microscopy study

“…Rhegmatogenous retinal detachment (RRD) represents one of the most serious and vision‐threatening ocular conditions, which needs immediate surgical treatment (Williamson et al. ). Despite pars plana vitrectomy (PPV) is gradually overcoming the other surgical approaches, SB still maintains clear indications in young and phakic patients (Brazitikos et al.…”

A simple mathematical model of rhegmatogenous retinal detachment

“…It should be noted that both the typical clinical presentation and the rate of progress of a retinal detachment vary amongst different subjects. The risk of total retinal detachment is important as this affects the anatomical and visual outcome [2,3].…”