Impact of Duration of Macula-Off Retinal Detachment on Visual Outcome

Bussel, Erik M. van; Valk, Rikkert van der; Bijlsma, Ward R; Heij, Ellen C. La

doi:10.1097/iae.0000000000000296

Cited by 80 publications

(73 citation statements)

References 23 publications

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“…Our study suggested that surgery up to 3 days after central VA loss resulted in best FVA (mean FVA of 0.25±0.21 logMAR compared with 0.29±0.24 logMAR in eyes repaired within 10 days (p<0.001)). This is in line with van Bussel et al 3 who showed FVA worsens already significantly after a maximal lag time of 3 days and deteriorates further with longer durations. According to our data, a pairwise comparison of eyes that had surgery at either day 1, 2 or 3 showed no statistically significant difference (p=1.00) in FVA.…”

Section: Discussionsupporting

confidence: 92%

“…Recently, van Bussel et al 3 reviewed articles published from 1995 to October 2013 of patients with macula-off RRD and treated with scleral buckling (SB) or pars plana vitrectomy (PPV). These authors reported a limitation of their study was that there were insufficient data about the final visual acuity (FVA) in patients who received surgery during the first 3 days after onset of central vision loss.…”

Section: Introductionmentioning

confidence: 99%

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Visual recovery after retinal detachment with macula-off: is surgery within the first 72 h better than after?

et al. 2016

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Our study suggests that 1. After 10 days of central visual acuity loss, the final visual outcome is clinically comparable and independent of further delay of surgery up to 30 days. 2. Eyes treated up to 3 days after onset of loss of central vision have better final visual acuity than eyes with longer lag time. However, we did not find statistically significant differences within the first 3 days. 3. Surgery for macula-off retinal detachment may therefore most likely be postponed without compromising the patient's visual prognosis.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Visual recovery after retinal detachment with macula-off: is surgery within the first 72 h better than after?

et al. 2016

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“…Although the current practice is to focus on early treatment of macula‐ON detachment as reflected by the median we found of 1 day, we should aim at scheduling earlier surgery of recent macula‐OFF detachment (van Bussel et al. ) to bring down the current median of 5 days.…”

Section: Discussionmentioning

confidence: 98%

What made you wait so long? Delays in presentation of retinal detachment: knowledge is related to an attached macula

Eijk

Busschbach

Timman

et al. 2016

Acta Ophthalmologica

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ABSTRACT.Purpose: In rhegmatogenous retinal detachment, the time between first symptoms and reattachment surgery is critical to prevent macular detachment. We explored which determinants discriminate between 'macula-ON' and 'macula-OFF' retinal detachments to improve timely treatment. Methods: Eight-hundred patients with rhegmatogenous retinal detachment admitted for surgery at the Rotterdam Eye Hospital in the Netherlands were eligible to complete a questionnaire to explore the following determinants: (i) patient's delay and doctor's delay; (ii) patient-reported causes for delay; (iii) symptoms as early warning signals; (iv) patient's prior knowledge about retinal detachment; and (v) trait anxiety. Results: Five hundred and twenty-one questionnaires (65%) were analysed. Median interval between first symptoms and surgery was 14 days. Macula-ON/OFF ratio was 46/54. Patient's delay in macula-ON patients (median 3 days) was shorter than in macula-OFF (5 days, p = 0.026). No difference was found in doctor's delay except for 'waiting time for surgery': macula-ON patients were operated on faster (median 1 day) than macula-OFF (median 5 days, p < 0.001). Macula-ON patients more often attributed symptoms to retinal problems. Except floaters, no symptoms were determined as early warning signals for macula-ON. Macula-ON patients more often reported knowing that prognosis would be worse when treated later, even when controlled for previous experience with retinal detachment. Conclusion: Macula-ON patients seem to self-refer faster to a healthcare provider, seem more sensitive to floaters and seem more informed. This suggests that increasing awareness, especially about floaters, might increase the proportion of patients with macula still on at the moment of referral to the ophthalmologist.

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“…It would thus have been interesting to add the results according to subgroups defined by the duration of macular detachment. 6,7 The location of retinal breaks is usually superior. In most superior RRD treated by vitrectomy and gas tamponade, the prescription of a strict face-down position for only several hours, once, is efficient to prevent the occurrence of a retinal displacement.…”

Section: To the Editormentioning

confidence: 99%

Correspondence

Soler

Mahieu

Matonti

et al. 2015

Retina

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Impact of Duration of Macula-Off Retinal Detachment on Visual Outcome

Abstract: This meta-analysis suggests that scleral buckling for macular detachment must preferably be performed within 3 days to optimize visual outcome.

Cited by 80 publications

References 23 publications

Visual recovery after retinal detachment with macula-off: is surgery within the first 72 h better than after?

Visual recovery after retinal detachment with macula-off: is surgery within the first 72 h better than after?

What made you wait so long? Delays in presentation of retinal detachment: knowledge is related to an attached macula

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