Pre-operative optical coherence tomography findings in macula-off retinal detachments and visual outcome

Purpose To evaluate the correlation between foveal changes in the detached retina in macula-off rhegmatogenous retinal detachments (RRD) and visual acuity outcome following repair. Design Retrospective, consecutive, observational case series. Methods Consecutive patients presenting with macula-off RRD between July 15 and September 15, 2017, underwent SD-OCT imaging and their medical records were reviewed. Specific OCT exam parameters were used to evaluate the fovea of the detached retina. Results In total, 47 patients with macula-off RRD were treated from July 15 to September 15, 2017. Forty-four eyes of 44 patients could be imaged by SD-OCT and were included in the analysis. Univariate analysis demonstrated a correlation between the height of the detachment, the duration of symptoms, the presence of macular hole and epiretinal membrane to the final VA. Correlation was also found between the presence of MH and the height of the detachment. However, multiple regression analysis demonstrated only a statistically significant correlation between the presence of a macular hole or an epiretinal membrane to the final VA. Conclusions Our study is the first to demonstrate the significance of foveal changes in the pathogenesis of lost vision in macula-off retinal detachments. The high rate of macular holes and the correlation between the MH and the height of the detachment suggest that elevated tension in the fovea in high detachments might play a significant role in the visual outcome of macula-off RRD following repair.