Predictive Factors for Long-Term Postoperative Visual Outcome in Patients with Macula-Off Rhegmatogenous Retinal Detachment Treated with Vitrectomy

Abstract

Purpose: The purpose of this prospective study was to evaluate potential predictive factors of long-term postoperative outcome in patients with macula-off rhegmatogenous retinal detachment (RRD), treated with pars plana vitrectomy (PPV). Methods: Participants in the study were 86 patients diagnosed with macula-off RRD, who underwent PPV. Demographic characteristics and preoperative characteristics of RRD were recorded, while best corrected visual acuity (BCVA) was measured preoperatively and at specific postoperative time-points (week 6 and months 6, 12 and 24). In addition, spectral domain-optical coherence tomography (SD-OCT) characteristics at postoperative week 6 were assessed as potential factors, affecting the long-term postoperative visual outcome 24 months after PPV for RRD. Results: Increasing age, duration of RD more than 1 week, presence of proliferative vitreoretinopathy, increasing central retinal thickness, ellipsoid zone disruption and external limiting membrane disruption were significantly associated with worse BVCA. BCVA was not associated with gender, lens status, location of breaks, gas tamponade agent used in PPV, presence of subretinal fluid and intraretinal fluid. Conclusions: It is important to determine predictive factors for visual outcome, so as to inform patients about prognosis and help in the decision-making of patients’ management.

Assessment of Vascular Changes in Patients after Pars Plana Vitrectomy Surgery Due to Macula-Off Rhegmatogenous Retinal Detachment

“…On the basis of the results from the OCT-A study, they found a statistically significant enlargement of the SCP FAZ and DCP FAZ in the study group after surgery compared to the control ( p < 0.05). The differences in the scores obtained by Chatziralli et al [ 45 ] and our group may result from the difference in the selection of control groups. Therefore, to address these discrepancies, one more control group should be included in future study [ 45 ].…”

“…The differences in the scores obtained by Chatziralli et al [ 45 ] and our group may result from the difference in the selection of control groups. Therefore, to address these discrepancies, one more control group should be included in future study [ 45 ].…”

“…Chatziralli et al [ 45 ] assessed changes in the retinal microvasculature in 89 RRD patients who underwent a PPV and gas endotamponade procedure without internal limiting membrane peeling. As a control, they used eyes from healthy volunteers rather than the patient’s healthy eye, as in our study.…”

Optical Coherence Tomography Findings in Rhegmatogenous Retinal Detachment: A Systematic Review

“…Studies conducted on macula-off retinal detachment showed that the baseline visual acuity and time to surgical repair are among the best predictors of vision outcomes [ 11 , 12 ]. The number of detached quadrants and the stage of proliferative vitreoretinopathy are also related to poor postoperative anatomical results and poor visual prognosis [ 11 , 12 , 13 ]. In addition, the integrity of the ellipsoid zone and the external limiting membrane is useful to predict postoperative visual acuity [ 12 , 14 , 15 , 16 , 17 ].…”

“…The number of detached quadrants and the stage of proliferative vitreoretinopathy are also related to poor postoperative anatomical results and poor visual prognosis [ 11 , 12 , 13 ]. In addition, the integrity of the ellipsoid zone and the external limiting membrane is useful to predict postoperative visual acuity [ 12 , 14 , 15 , 16 , 17 ]. However, Sridhar and colleagues reported that two patients with macula-off retinal detachment experienced a postoperative improvement in visual acuity secondary to ellipsoid zone restoration [ 18 ].…”