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Phillip Paulk, Jason Crosson, Thomas A. Swain, Dala Eloubeidi; Macula-Off Rhegmatogenous Retinal Detachment (RRD) Outcomes in Age-Related Macular Degeneration (AMD) versus Non-AMD Eyes. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3740.
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No studies have evaluated visual outcomes in patients with macula-off RRD with concomitant AMD. AMD patients presenting with macula-off RRD as well as the physicians treating these patients need to know the visual prognosis after retinal detachment repair. The purpose of this study is to compare visual outcomes in macula-off RRD in eyes with AMD versus a group of control eyes without AMD.
This was a retrospective chart review of 1,149 patients. Inclusion criteria included eyes with macula-off RRD that underwent surgical repair between years 2013-2017. Exclusion criteria included the following: mac-on RRDs, exudative RDs, tractional RDs, recurrent RDs, eyes with less than 6 months of follow up, or eyes with pre-existing retinal disease (other than AMD). A total of 253 eyes met study criteria, 222 non-AMD eyes (controls) and 31 AMD eyes (27 dry AMD, 4 wet AMD). Visual acuity outcomes in control eyes versus AMD eyes were compared using Fisher’s exact test.
There was no statistically significant difference in postoperative visual acuity between non-AMD eyes and AMD eyes after RD repair.. More specifically, 33.8% of non-AMD eyes and 22.6% of AMD eyes had 20/40 or better visual acuity, 46.4% of non-AMD and 41.9% of AMD eyes had visual acuity equal to or worse than 20/40 and better than 20/200, and 19.8% of non-AMD eyes and 35.5% of AMD eyes had 20/200 or worse visual acuity (p = 0.1366). In the study 82.4% of the non-AMD eyes and 80.6% of AMD eyes had improved vision after RD repair (p = 0.8034).
There was no significant difference in postoperative visual acuity in AMD eyes when compared to normal eyes after RRD repair. However, as one might expect, there was a higher proportion of better visual acuity outcomes in patients without AMD. Still, visual acuity improved in the majority of all patients—AMD and non-AMD eyes alike. Our study suggests that approximately 20% of patients with dry AMD can expect to maintain reading vision after macula-off RRD repair. This is not far behind the one-third of patients (both in our study and in prior studies) without AMD that typically achieve this level of vision. We conclude that AMD patients can achieve functional vision after retinal detachment surgery. These findings may be helpful in guiding realistic expectations of AMD patients with RRD.
This is a 2020 ARVO Annual Meeting abstract.
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