Effect of Timing on Visual Outcomes in Fovea-Involving Retinal Detachments Verified by SD-OCT

Abstract

Purpose. To investigate the impact of surgical delay after the objectivation of the foveal status by spectral-domain optical coherence tomography (SD-OCT) on visual outcomes in patients with rhegmatogenous retinal detachment (RRD) with foveal involvement. Methods. A retrospective dataset analysis of 508 eyes of 504 consecutive patients with primary RRD was performed. The primary outcome measure was the best-corrected visual acuity as a function of time between the assessment of the foveal status with SD-OCT upon initial examination at the department and RRD repair. Results. In total, 188 eyes (37.0%) had a complete foveal detachment and 31 (6.1%) eyes had a bisected fovea by the retinal detachment. A hundred eyes with total foveal detachment received surgery within 24 h and 65 eyes between 24 h and 72 h. Visual outcomes for eyes with detached fovea were significantly better when treated within 24 h (0.47 ± 0.39) compared with those treated between 24 h and 72 h (0.84 ± 0.66; p=0.01) after objectivation of the foveal status with SD-OCT. Pars plana vitrectomy was performed in 174 (92.6%) eyes and scleral buckling surgery in 14 (7.4%) eyes with complete foveal involvement of RRD. Conclusions. Our findings suggest improved visual outcomes for patients receiving surgery within 24 h after a definitive diagnosis of fovea-involving RRD compared to surgical interventions that were further delayed.

Differential Response of Müller Cells and Microglia in a Mouse Retinal Detachment Model and Its Implications in Detached and Non-Detached Regions

“…TUNEL-positive cells were first observed in the detached region 1 day after RD, prominently increased from 3 days after RD, and peaked at 5 days after RD (Figure 2). These findings reveal that photoreceptor degeneration starts early (<24 h), accelerates, and rapidly subsides within a week, suggesting that surgical intervention is recommended in early RD [29]. In addition, we observed an indispensable number of TUNEL-positive cells in the border region near the detached region, while histological findings showed thinned ONL.…”

Early Structural and Vascular Changes after Within-24 Hours Vitrectomy for Recent Onset Rhegmatogenous Retinal Detachment Treatment: A Pilot Study Comparing Bisected Macula and Not Bisected Macula

“…Despite this, no significant differences in final postsurgical BCVA were detected between the two subgroups. This is in accordance with previous studies, where the progression of detachment to macular involvement does not consistently influence visual functional recovery if surgery is performed very quickly (within 24 hours) [ 26 , 37 , 38 ]. No significant correlation was found between BCVA and FAZ in both the SCP and DCP as well.…”

Amotio-retinae-Versorgung während der Corona-Pandemie

“…Der funktionelle Erfolg ist v. a. abhängig von einer Mitbeteiligung der Makula [ 6 , 13 ]. Das Risiko einer Makulabeteiligung steigt dabei mit zunehmender Dauer der Netzhautablösung signifikant an [ 1 , 4 , 9 ].…”