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O. Calvetti, T. Rodallec, E. Blumen–Ohana, C. Baudouin, J.–P. Nordmann; Visual Recovery of Macula–Off Rhegmatogenous Retinal Detachment and Six Months Follow–up With Optical Coherence Tomography of the Macula . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5477.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:To observe the macula of rhegmatogenous retinal detachment (RD) involving the macula after scleral buckling and to study the relationship between visual acuity (VA) pre– and post– surgery and the optical coherence tomography (OCT) image during six months. Methods: Prospective study of 34 patients that had surgery with scleral buckling for RD. We included in the study patients with macula–involved rhegmatogenous RD, who had no pre–existing ocular disease, the time period between the onset of RD and surgery was less than 30 days. Fundus examination, VA and OCT were performed at one month and at six months post surgery. Results: Fundus examination indicated that all RD were reattached at one month postoperatively. Accumulation of subretinal fluid (SRF) at the macula was observed in eleven (32%) cases with OCT. In 8/11 (23%) SRF persisted up to 6 months after the operation. The presence of SRF did not influence visual recovery during this period, comparing VA between patients with and without SRF (one month: p=0,29; six months: p=0,25). Cystic macular edema (CME) was observed in seven (20%) cases with OCT at one month. For four of these patients CME persisted up to 6 months after retinal surgery. The CME reduced severely the improvement of VA comparing between patients with or without CME (one month :p=0,0031; six months: p=0,0047). A significant difference existed in visual recovery at one month (p=0,0033) and at six months (p=0,0018) between patients that underwent retinal surgery after seven days of RD duration or within the first week of RD. No significant difference in CME with OCT at one (p=0,30) and at six months (p=0,51) appears between patients that underwent surgical repair within the first week of macula–off RD compared to patients that underwent retinal surgery after the first week. Conclusions: Our study shows that presence or not of subretinal fluid in OCT did not influence visual recovery, on the other hand CME reduce severely the recovery of VA. Patients with a duration of RD more than seven days had no more CME or subretinal fluid than patients who underwent surgery within the first week. When the VA recovery is low for patients operated before the seventh day, OCT seemed to be necessary. Thus OCT may be of interest for evaluation of the cause of poor recovery after RD, especially in those patients operated during the first week. In case of CME specific treatments based on OCT findings may be useful.
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