Optical Coherence Tomography Findings in Eyes with Spontaneous Reattachment of Macula-off Traction Retinal Detachments

Abstract

Purpose : To describe the clinical course and optical coherence tomography (OCT) findings in eyes with spontaneous reattachment of macula-off traction retinal detachments (TRD).

Methods : Retrospective case series of eyes with macula-off TRD that had spontaneous reattachment.

Results : Four eyes of 4 patients with macula-off TRD secondary to proliferative diabetic retinopathy (PDR) (n=3) and proliferative sickle cell retinopathy (n=1) were included. Median (IQR) age was 47.5 (22.8) years. Two of 3 PDR eyes each had 1 anti-VEGF injection at the visit prior to the macula-off TRD, with a median time from injection to TRD of 204 days [range 42-365 days]. Two of 3 PDR eyes had prior panretinal photocoagulation before TRD. OCT confirmed spontaneous resolution of the macular retinal detachment (Figure 1) in all eyes. Median (IQR) logMAR VA at the time of macula-off TRD was 0.544 (0.452) [Snellen 20/70] which improved to a median (IQR) logMAR VA of 0.350 (0.156) [Snellen 20/45, p=0.068] at the first visit with reattachment characterized by OCT. Median (IQR) time from TRD diagnosis to OCT measured reattachment was 6 months, (10.25; range 1-12 months). No complete posterior vitreous separation was seen in any of the eyes. One eye had a recurrent TRD 4 months after initial spontaneous reattachment. The macula remained attached until the last visit in the other eyes at a median of 365 days [range 266-469 days] after the TRD diagnosis. The final median logMAR VA of these three eyes was 0.544 (range 0.301-0.544) [Snellen 20/70, p=0.18].

Conclusions : Non-surgical spontaneous retinal reattachment and significant visual acuity improvement may rarely occur in eyes with TRD. In our cases, no OCT evidence of posterior vitreous separation was found, suggesting that some relaxation of the contractile fibrovascular membranes may have occurred to account for macula reattachment.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

A: Baseline presentation with detachment of the entire macula, B: Spontaneous reattachment of the macula