Purpose: To study the clinical characteristics of macula off rhegmatogenous retinal detachment (RRD) with peripheral causative breaks and concomitant macular hole (MHRD).
Methods: This is a Bi-center study. Consecutive eyes of macula off RRD with or without macular hole (MH) were collected. Eyes in these 2 groups were compared with best corrected visual acuity in logarithm of minimal angle of resolution (logMar BCVA), presence of choroidal detachment (CD), proliferative vitreoretinopathy (PVR) and the extent of RRD. In the group of MHRD, regression analysis was used to evaluate the correlation of clinical factors and final logMar BCVA. In addition, optical coherence tomography was performed both pre-and post- operatively if possible.
Results: There were 40 eyes in the MHRD group and 80 eyes in the control group. Eyes with MHRD had worse initial and final logMar BCVA (p<0.001), higher incidence of CD (p<0.001), PVR and extensive RRD at baseline (p<0.001). Among the eyes with MHRD, final BCVA was correlated with initial BCVA(p<0.001 , CI: 0.637 to 0.837), recurrent RRD (p=0.004, CI: -0.661 to -0.126), duration of RRD ( p=0.021, CI: -0.576 to -0.048) and presence of PVR (p=0.001, CI: -0.131 to -0.035). The hole closure rate at final follow up is 87.5%.11 of the 17 eyes had preoperative OCT obtained had ellipsoid zone lining the bottom of MH.
Conclusion: CD, PVR and extensive RRD were more commonly observed in MHRD. The morphology of MH suggests the pathogenesis of MH in MHRD include mechanism different from that of idiopathic MH.