Optical Coherence Tomography Analysis of the Macula after Macula-off Rhegmatogenous Retinal Detachment Surgery

Background: To define the incidence, duration, and clinical associations of persistent foveal retinal detachment and central foveal thickness after macula-off rhegmatogenous retinal detachment (RRD) surgery, using optical coherence tomography (OCT). Methods: Prospective study. Thirty-nine patients with macula-off RRD after successful RD repair, from January 2006 to Februrary 2007. Using OCT, we prospectively examined cross-sectional retinal images of 39 eyes of 39 consecutive patients who underwent surgery for the treatment of RRD. The patients were divided into two groups and it was non randomized. Primary scleral buckling (SB) was performed on 18 eyes of 18 patients, and 21 eyes of 21 patients were treated with pars plana vitrectomy (PPV) and SF6 tamponade with or without SB. All eyes underwent clinical examination and OCT postoperatively at two weeks, and one, three, and six months. Postoperative OCT findings and best-corrected visual acuity (BCVA) were analyzed statistically. Results: The patients’ ages ranged from 17 to 63 years (mean, 46.5±15 years). The time from the onset of subjective symptoms to retinal surgery ranged from 4 to 56 days (mean, 15±16 days). BCVA in logMAR units ranged from 0.3 to 1.47 before retinal surgery (mean, 0.96±0.15). OCT showed residual foveal detachment in 11 eyes (28.2%) and in adjacent areas one month after surgery. The remaining 28 retinas (71.8%) were attached when examined tomographically. In six of the 11 eyes (54%) with residual foveal detachment due to subretinal fluid (SRF) on OCT, the retinas reattached spontaneously within six months after surgery. Postoperative BCVA improved over three months in both groups. There was a decrease in the absolute difference value between the central foveal thickness of the lesion eye and that of the contralateral eye in each patient. But the correlation coefficient was not statistically significant (P=0.113). Conclusion: Increased macular thickness due to SRF after retinal detachment surgery may persist for several months, and tends to cause delayed visual recovery.