The Correlation between Height of Macular Detachment and Visual Outcome in Macula-Off Retinal Detachments of ≤7 Days’ Duration

Ross, William H.; Lavina, Adrian; Russell, Matthew W; Maberley, David

doi:10.1016/j.ophtha.2005.01.040

Cited by 77 publications

(89 citation statements)

References 18 publications

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“…[23][24][25] The results presented here demonstrate that there is a worse outcome following foveal involvement and therefore, as the rate of detachment cannot be accurately predicted, Table 2 The proportion of patients with 6/9 vision or better at follow-up and the relationship with variables that were significantly related to follow-up vision after multivariate analysis 6/9 or better vision with variable (%) surgeons need to perform prompt surgery for fovea on detachments to avoid progression and foveal detachment. 26 Surgeons have been reassured by publications that show no difference in visual recovery in patients with foveal off RRD and varying duration of symptoms in the first week [27][28][29][30][31] or first 10 days. 32 This has lead to Ross et al 29 suggesting that macular off RRD can wait for a scheduled operating list.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of rhegmatogenous retinal detachment and their relationship to visual outcome

Williamson

Shunmugam

Rodrigues

et al. 2013

Eye

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Aims To examine pre-operative characteristics of rhegmatogenous retinal detachment (RRD) and their relationship to visual acuity (VA) following surgery. Methods Review of prospectively completed electronic database. Baseline characteristics, retinal drawings and outcomes were analysed. Results In all, 847 eyes from 847 patients with a mean age of 62.2 years, 60% males, and 56% right eyes were studied. Mean follow-up was 9.6 months. Preoperative VA correlated with final VA (r 2 ¼ 0.21, Po0.0001). Median postoperative VA was 6/9 (Logmar 0.18, quartiles ¼ 0.0-0.48) and was significantly related to anatomical success: 70.15% achieved 0.18 or better with fully attached retina and primary success, whereas only 8.33% achieved this when the retina was not fully attached at final follow-up (failure) (Po0.0001). Univariate analysis found multiple variables associated with achieving 0.18 postoperative vision, however, multivariate analysis revealed only primary anatomical success with surgery; absence of proliferative vitreo-retinopathy (PVR), betterpresenting VA and fewer quadrants of detachment were associated with a better visual outcome (r 2 ¼ 0.26, Po0.0001). Patients with a clinically attached fovea achieved better vision than patients with a clinically detached fovea, independent of the visual loss duration. With foveal detachment however, postoperative VA was better in patients with 1-3 days of visual loss compared with 4-6 days (P ¼ 0.013). Conclusions Failure of primary surgery, PVR, extensive RRD and poor-presenting VA are risk factors for poorer visual outcome following surgery for RRD. Fovea off RRD at presentation achieved poorer postoperative VA than fovea attached and visual outcome was poorer when there was a longer duration of visual symptoms.

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Section: Discussionmentioning

confidence: 99%

Characteristics of rhegmatogenous retinal detachment and their relationship to visual outcome

Williamson

Shunmugam

Rodrigues

et al. 2013

Eye

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“…Ross and Kozy 1 had shown that the final visual outcome is not affected by the duration of the macular detachments for macula-off retinal detachments of p7 days duration, but by the height of the macular detachment. 5 There are no other published studies using B Scan ultrasound (US) to assess the macular height with correlation to visual outcome. A review of the literature establishes that pre-op visual acuity, duration of macular detachment, absence of proliferative retinopathy, age of patient, and now, macular height can assist the clinician in determining the visual prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] Macular height estimation by ultrasound (US) has been shown to have a positive correlation for retinal detachments of p7 days duration. 5 The aim of our study is to assess the effect of macular height on visual recovery in macula-off retinal detachments at the Wolverhampton Eye Infirmary.…”

Section: Introductionmentioning

confidence: 99%

Correlation of visual recovery with macular height in macula-off retinal detachments

Mowatt

Tarin

Nair

et al. 2009

Eye

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Objectives To determine the relationship between the preoperative macular height of a macular detachment and visual outcome of the post retinal reattachment. Methods Prospective case series of 26 patients who presented to the Wolverhampton Eye Infirmary with a primary rhegmatogenous macula-off retinal detachment. Macular detachment height was assessed by B-scan ultrasound (10 Mhz) in the seated and supine postures before surgery. Age, gender, duration of the detachment, type of surgery, preoperative (pre-op) and postoperative (post-op) visual acuities at 3 and 6 months and status of the fellow eye were noted. Results A total of 26 eyes of 26 patients (mean age: 61.4 years±15.56 SD) were recruited. The mean logMAR pre-and post-op visual acuities at 3 and 6 months were 1.5 ± 1.1 SD (range: 0.2-3), 0.38 ± 0.23 SD (range: 0-0.84), and at 6 months 0.29 ± 0.22 SD (range: 0-1.0). The median period of the macular detachment was 4.5 days (95% CI: 2-8 days). There was no significant difference between the mean macular heights while seated 2.42 mm±1.2 or supine 2.39 mm ± 1.0 (t-test, P ¼ 0.9). Correlation showed that the pre-op macular height is a statistical predictor of post-op visual acuity in our group of patients with macula-off retinal detachments. Conclusions The shallower the macular detachment the greater the likelihood of a good visual outcome.

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“…3,4 Three important predictors of visual recovery are pre-operative visual acuity, shorter duration of RD, and younger age. 5 However, some patients with an apparently normal macula after an uncomplicated and timely scleral-buckling procedure may experience incomplete visual recovery and persistent metamorphopsia. 6 The aim of this paper was to perform a prospective study of the anatomical and functional findings of a series of eyes which underwent successful RD surgery, but showed post-operative metamorphopsia and slow visual acuity recovery.…”

Section: Introductionmentioning

confidence: 99%

Long-term follow-up with optical coherence tomography and microperimetry in eyes with metamorphopsia after macula-off retinal detachment repair

Rossetti

Doro

Manfre

et al. 2010

Eye

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Purpose To report the long-term sequential morphological and functional results in eyes with metamorphopsia after retinal detachment (RD) repair. Patients and methods In six eyes of six patients aged 58.7±11.0 years with metamorphopsia after successful buckling surgery for macula-off RD, best-corrected visual acuity (BCVA), fundus biomicroscopy, Amsler grid test, time-domain optical coherence tomography (TD-OCT) and central 121 microperimetry (MP-1) were performed at months 1, 3, 6, 12, and 18. At 5 to 6 years after surgery all patients underwent also spectral domain (SD)-OCT. Results Three eyes slowly recovered pre-RD BCVA. In the remaining three eyesFwith good final BCVAFthe interrupted junction line between photoreceptor cell inner and outer segments (IS/OS) was progressively less evident after RD surgery; and the external limiting membrane was preserved on SD-OCT examination. In all eyes post-operative metamorphopsia faded with time, but fully disappeared in 6 years only in two eyes without photoreceptor abnormalities. One of the two eyes with subretinal fluid up to 6 months and IS/OS disruption had central dense scotoma with relatively unstable fixation on MP-1 and persistent metamorphopsia. Macular sensitivity (MS) increased from 9.7 ± 7.1 at month 1 to 13.5 ± 5.6 dB at the final check, and was weakly (r ¼ 0.33) correlated with post-operative BCVA and OCT abnormalities. Conclusion Long-standing metamorphopsia can occur after successful macula-off RD repair even without detectable photoreceptor disruption on OCT. Post-operative BCVA recovery weakly correlates with increasing MS, and late restoration of the photoreceptor layer may be observed

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The Correlation between Height of Macular Detachment and Visual Outcome in Macula-Off Retinal Detachments of ≤7 Days’ Duration

Cited by 77 publications

References 18 publications

Characteristics of rhegmatogenous retinal detachment and their relationship to visual outcome

Characteristics of rhegmatogenous retinal detachment and their relationship to visual outcome

Correlation of visual recovery with macular height in macula-off retinal detachments

Long-term follow-up with optical coherence tomography and microperimetry in eyes with metamorphopsia after macula-off retinal detachment repair

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