Abstract
Purpose :
To assess if there is a correlation between macular microstructure alterations detected by spectral-domain optical coherence tomography (OCT) and visual acuity after primary pars-plana vitrectomy (PPV) to repair rhegmatogenous retinal detachment (RRD).
Methods :
Inclusion criteria were patients with recent RRD, phakic or pseudophakic, macula on or macula off and proliferative vitreoretinopathy grade A-B. Exclusion criteria were uveitis, glaucoma, diabetes, proliferative vitreoretinopathy grade CA-CP. 41 eyes of 41 patients with recent onset RRD who had PPV were included in this retrospective study. Visual acuity (VA) and retinal changes on OCT were evaluated after surgery.
Results :
All patients underwent a follow up visit after 6 months. Patients with macula on were 34.1% and macula off were 65.9%. Considering VA before surgery, patents with macula on were divided into Group 1 (VA < 20/32) and Group 2 (VA > 20/32). Patients with macula off were divided into Group 3 (VA < 20/250) and Group 4 (VA > 20/250). Group 1 patients with macula on had a VA higher than 20/32 in 70% of cases, even in presence of new onset RPE abnormalities (15%), internal limiting membrane thickening (33%) and extrafoveal outer retinal folds (33%). In this group VA was lower than 20/32 in 30% of cases and OCT showed new onset RPE abnormalities and extrafoveal outer retinal folds; 70% of these were myopic. Group 2 patients with macula on had a VA higher than 20/32 in 100% of cases. These patients showed new onset RPE abnormalities in 15% and internal limiting membrane thickening in 15% of cases. Group 3 patients with macula off had a VA higher than 20/250 in 70% of cases. The alterations detected by OCT were 100% on the RPE band and outer retina abnormalities in foveal area, in 40% of these patients there were also inner retina abnormalities. Thirty percent of patients in Group 3 had a VA lower than 20/250 and the alterations detected by OCT, namely RPE band, outer and inner retina abnormalities in foveal area resulted in 100% of cases. In Group 4, VA was 20/32 or higher even in presence of new onset RPE band abnormalities (60%), internal limiting membrane thickening (40%), extrafoveal outer retinal folds (40%).
Conclusions :
The majority of macular microstructural changes detected by OCT are correlated to the visual outcomes of retinal detachment repair.
This is a 2020 ARVO Annual Meeting abstract.