First Author: G.Weigert AUSTRIA
Co Author(s): K. Eibenberg S. Sacu S. Rezar-Dreindl U. Schmidt-Erfurth M. Georgopoulos
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To investigate the relation of demographic, clinical and morphologic OCT characteristics on the visual outcome of fovea-off rhegmatogenous retinal detachment (RRD).
In this prospective, observational study 257 patients with primary fovea-off RRD were included. The study was conducted at the department of ophthalmology, medical university Vienna between January 2008 and December 2014. Patients with RD due to other causes and no postoperative visual acuity (VA) were excluded from the study.
Patients were divided into two groups according to their last VA (group 1: VA>20/40; group 2: VA<20/40). The influence of various demographic (age, gender, refractive error, lens, vitreous, grade of PVR) RD, (extent, number of defects, type of surgery, number of cryocoagulation (CC) spots, intraocular tamponade) and morphologic characteristics of the preoperative OCT (cysts in the outer or inner nuclear layer (ONL, INL) and edema/atrophy of the retina) on the visual outcome was analyzed.
156 male and 101 female patients were divided into group 1 including 155 and group 2 including 102 patients. Mean age was 59.8±12.6 years. No significant difference was found for gender (p=0.13), age (p=0.26) or refractive error (p=0.11). For lens status, pseudophakia was more commonly found in group 1 (n=63), whereas cataract in group 2 (n=52; p=0.014). PVR grade C was increased in group 2 (n=29), whereas no PVR in group 1 (n=35; p<0.001). A total detachment was found more often in group 2 (n=30) and a one- or two-quadrant RD in group 1 (1-quadrant n=14; 2-quadrant n=84; p=0.001). The number of defects was similar in both groups (p=0.64). Whether scleral buckle, vitrectomy or a combination was performed, did not differ between the groups (p=0.06). The number of CC spots (p=0.84) showed no significant difference, however silicone oil was used more often as the intraocular tamponade in group 2 (n=29; p<0.0001). Morphologic evaluation of preoperative OCTs showed no significance for ONL or INL cysts for both groups, whereas atrophy of the retina is significantly more common in group 2 (p=0.005).
More than half of the patients with fovea-of RRD showed a good visual recovery. In general, a better visual outcome was found in patients with pseudophakia, one- to two-quadrant RD and no sign of PVR than with total RD, PVR grade C and use of silicone oil. Atrophy of the preoperative foveal structure showed a worse visual outcome.