Correlation of visual recovery with macular height in macula-off retinal detachments

Abstract

Objectives To determine the relationship between the preoperative macular height of a macular detachment and visual outcome of the post retinal reattachment. Methods Prospective case series of 26 patients who presented to the Wolverhampton Eye Infirmary with a primary rhegmatogenous macula-off retinal detachment. Macular detachment height was assessed by B-scan ultrasound (10 Mhz) in the seated and supine postures before surgery. Age, gender, duration of the detachment, type of surgery, preoperative (pre-op) and postoperative (post-op) visual acuities at 3 and 6 months and status of the fellow eye were noted. Results A total of 26 eyes of 26 patients (mean age: 61.4 years±15.56 SD) were recruited. The mean logMAR pre-and post-op visual acuities at 3 and 6 months were 1.5 ± 1.1 SD (range: 0.2-3), 0.38 ± 0.23 SD (range: 0-0.84), and at 6 months 0.29 ± 0.22 SD (range: 0-1.0). The median period of the macular detachment was 4.5 days (95% CI: 2-8 days). There was no significant difference between the mean macular heights while seated 2.42 mm±1.2 or supine 2.39 mm ± 1.0 (t-test, P ¼ 0.9). Correlation showed that the pre-op macular height is a statistical predictor of post-op visual acuity in our group of patients with macula-off retinal detachments. Conclusions The shallower the macular detachment the greater the likelihood of a good visual outcome.

Association Between Photoreceptor Regeneration and Visual Acuity Following Surgery for Rhegmatogenous Retinal Detachment

“…Factors previously reported to be associated with functional recovery after macula-off RRD included preoperative VA, 12 duration of macular detachment, 6,8 height of macular detachment, 13,14 and age. 12 In the present study, the presence of a foveal bulge was the only significant independent predictor of final BCVA.…”

“…5 Persistent functional damage to the macula is observed in a proportion of eyes affected by macula-off RRD. [6][7][8][9][10][11] Factors reportedly associated with functional recovery following macula-off RRD include preoperative VA, 12 duration of macular detachment, 6,8 height of macular detachment, 13,14 and age. 12 Even among eyes predicted to have good postoperative vision due to good preoperative conditions and the absence of significant complications during surgery, some eyes continue to have poor VA.…”

Outcome of surgery after macula‐off retinal detachment – results from MUSTARD, one of the largest databases on buckling surgery in Europe. Results from a large German case series

“…Another recent study has established the height of macular detachment as a statistical predictor of postoperative visual acuity. Supposedly, the shallower the macular detachment is, the greater the likelihood is of a good visual outcome is supposed to be (Mowatt et al 2009). …”

Postoperative Recovery of Visual Function after Macula-Off Rhegmatogenous Retinal Detachment

“…The few studies on the influence of the height and the duration of the macular detachment on the postoperative recovery of VA [23], [24] found that - within the first week of macular detachment - a lower height of macular detachment was associated with better postoperative visual acuity. Furthermore, previous studies relate to the outcomes for patients who have undergone “conventional” (buckling) surgery.…”

“…[2], [9], [11], [14], [18]–[22] However, in recent years trans pars plana vitrectomy (TPPV) is often used as a primary procedure, which might affect postoperative recovery. [30] Finally, follow-up periods in these studies ranged from 3 to 24 months, [2], [9], [11], [14], [18]–[21], [23], [24] whereas it is known that postoperative VA can improve gradually, reaching a maximum value between 6–12 months postoperatively. [10], [31] …”