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Pre-operative optical coherence tomography findings in macula-off retinal detachments and visual outcome

Abstract

Purpose

To evaluate the correlation between foveal changes in the detached retina in macula-off rhegmatogenous retinal detachments (RRD) and visual acuity outcome following repair.

Design

Retrospective, consecutive, observational case series.

Methods

Consecutive patients presenting with macula-off RRD between July 15 and September 15, 2017, underwent SD-OCT imaging and their medical records were reviewed. Specific OCT exam parameters were used to evaluate the fovea of the detached retina.

Results

In total, 47 patients with macula-off RRD were treated from July 15 to September 15, 2017. Forty-four eyes of 44 patients could be imaged by SD-OCT and were included in the analysis. Univariate analysis demonstrated a correlation between the height of the detachment, the duration of symptoms, the presence of macular hole and epiretinal membrane to the final VA. Correlation was also found between the presence of MH and the height of the detachment. However, multiple regression analysis demonstrated only a statistically significant correlation between the presence of a macular hole or an epiretinal membrane to the final VA.

Conclusions

Our study is the first to demonstrate the significance of foveal changes in the pathogenesis of lost vision in macula-off retinal detachments. The high rate of macular holes and the correlation between the MH and the height of the detachment suggest that elevated tension in the fovea in high detachments might play a significant role in the visual outcome of macula-off RRD following repair.

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Fig. 1: OCT findings in the detached macula.
Fig. 2: Suggested mechanism for macular hole formation in a high macula-off detachment.

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Authors

Contributions

AH was responsible for designing the protocol, writing the protocol and report, conducting the statistics, extracting and analysing data, interpreting results and summary the finding. RT contributed to writing the report, extracting and analysing data and interpreting results. AA contributed to extracting and analysing data, interpreting results and writing the protocol. PK and KE contributed to designing the protocol.

Corresponding author

Correspondence to Avner Hostovsky.

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The authors declare that they have no conflict of interest.

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Hostovsky, A., Trussart, R., AlAli, A. et al. Pre-operative optical coherence tomography findings in macula-off retinal detachments and visual outcome. Eye (2021). https://doi.org/10.1038/s41433-021-01399-z

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