Visual Outcomes for Patients with Primary Macula-Off Rhegmatogenous Retinal Detachment in a Colorado Cohort

Abstract

Purpose : To determine predictors of best corrected post-operative visual acuity of patients who underwent surgical intervention using standard repair techniques for macula-off retinal detachment in a Colorado Cohort.

Methods : A retrospective cohort study was conducted on 182 patients with macula-off retinal detachments drawn from The University of Colorado Primary Rhegmatogenous Retinal Detachment Database (2012-2015). There were 111 patients excluded secondary to concomitant factors such as diabetic retinopathy, glaucoma, uveitis, age-related macular degeneration, trauma, giant retinal tears, branch retinal vein occlusion, macular hole/pucker, retinoschisis, re-detachment and a missing Snellen visual acuity (VA) at 6 or more months post-surgery. The main outcome was a post-op VA of 20/40 or better at least 6 months after surgery. Risk factors examined were: number of breaks (1, 2-4, 5 or more), time of detachment symptoms to surgery (0-3 days, 4-7 days, 8-14 days, 15-68 days, and uncertain duration), and pre-op Snellen VA (20/200 or better, worse than 20/200, missing). Time of detachment symptoms was defined as number of days from the onset of vision loss in the central visual field until surgical intervention. Univariate logistic regression was used to analyze the data (P<0.05).

Results : The 71 patients included in the analytic database were mostly male (64.8%) and white (76.1%). The mean (± standard deviation) age at the time of surgery was 60.2± 11.8 years. Half of the patients had a post-op Snellen of 20/40 or better. The number of breaks and the time of detachment symptoms to surgery were not associated with VA outcome. Pre-op VA was associated with a post-op VA of 20/40 or better (Table). We observed that patients who were less cognizant of their symptoms were more likely to have a poor visual outcome than those who were able to report the duration of their detachment symptoms (Table).

Conclusions : In this cohort we found a significant relationship between the pre-op and post-op VA. Although limited by small sample size, we found that the number of breaks and time of detachment symptoms were not significantly associated with post-op VA. We continue to collect data and are beginning an initiative to assess the functional quality of vision with other modalities beyond VA.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.