USA: A retrospective study by Anton Orlin and the team revealed that a lower mean preoperative central retinal thickness in patients with macula-off rhegmatogenous retinal detachment is tied to a good visual prognosis. However, those having postoperative ellipsoid zone disruption in the eyes were less likely to have a good final vision. The findings of the study are published in Retina, the Journal of Retina and Vitreous Diseases.
Optical coherence tomography (OCT) imaging plays is crucial for the diagnosis and treatment of macular diseases, including those of the vitreomacular interface. Rhegmatogenous retinal detachment is the separation of the neurosensory retina from retinal pigment epithelium in association with the accumulation of subretinal fluid during retinal breaks. A significant amount of visual loss is reported especially when the macula is involved.
Dr. Orlin and colleagues aimed to identify any prognostic associations between preoperative optical coherence tomography findings and postoperative visual outcomes in patients with macula-off rhegmatogenous retinal detachment.
The study was a retrospective, single-center study of patients diagnosed with macula-off rhegmatogenous retinal detachment who underwent surgical reattachment from 2012 to 2017. Optical coherence tomography images were analyzed by two retina surgeons. Outcome measures included "good" final vision (visual acuity of 20/40 or better), "poor" final vision (visual acuity of 20/200 or worse), and change in vision (worsened, improved, and improved ≥15 letters) at the most recent follow-up. P values were calculated using t-tests, analysis of variance, Wilcoxon rank-sum, or Kruskall–Wallis test.
A total of 49 eyes were included.
The results of the study were
• There was a significant difference in the mean preoperative central retinal thickness between patients who had good final vision and patients who did not (96 μm vs. 161 μm).
• In addition, a worse preoperative best-corrected visual acuity and greater subretinal fluid height were associated with vision improvement.
• Those with persistent ellipsoid zone disruption postoperatively were less likely to have good final vision (odds ratio = 0.217).
Guan and the team concluded that "A lower mean preoperative central retinal thickness is associated with good visual prognosis. Eyes with ellipsoid zone disruption postoperatively were less likely to have good final vision. Future studies should include a larger cohort of patients and more optical coherence tomography variables to address the inconsistencies in the current literature."
Reference
Guan, Ivan BS*; Gupta, Mrinali P. MD†; Papakostas, Thanos MD‡; Wu, Alan MS§; Nadelmann, Jennifer MD¶; D'Amico, Donald J. MD‡; Kiss, Szilard MD‡; Orlin, Anton MD‡ ROLE OF OPTICAL COHERENCE TOMOGRAPHY FOR PREDICTING POSTOPERATIVE VISUAL OUTCOMES AFTER REPAIR OF MACULA-OFF RHEGMATOGENOUS RETINAL DETACHMENT, Retina: October 2021 - Volume 41 - Issue 10 - p 2017-2025 doi: 10.1097/IAE.0000000000003162