The following is a summary of “OCT analysis of preoperative foveal microstructure in recent-onset macula-off rhegmatogenous retinal detachment: visual acuity prognostic factors,” published in the May 2024 issue of Ophthalmology by Savastano et al.
Rhegmatogenous retinal detachment (RRD) is a common retinal detachment requiring surgical interventions
Researchers conducted a retrospective study to verify whether patients who opted for macula-off RRD improved postoperative visual acuity based on preoperative optical coherence tomography (OCT) morphological features.
They used patient data from 2020 to 2023 involving 89 eyes of patients who had surgery for macula-off RRD at Policlinico Universitario Agostino Gemelli. Preoperative 6×6 mm OCT B scans foveal status (fovea-on vs. fovea-off), subretinal hyper-reflective points (HRPs), outer retinal corrugations (ORCs), and intraretinal cystic spaces (ICS) in the outer nuclear layer. Best-corrected visual acuity (BCVA) outcomes were assessed over 6-month follow-up.
The results showed that Preoperative mean BCVA was 0.15 ±0.22, improving to 0.29 ±0.3 at 6 months (P<0.001). Subretinal HRPs and foveal detachment negatively impacted BCVA improvement (univariate analysis: HRPs r= -0.264, P=0.024; foveal detachment r= -0.355, P=0.012). Other OCT features were affected minimally by BCVA improvement: ORCs (r=0.072, P=0.257) and ICS (r= -0.020, P=0.734). In multivariate analysis, foveal detachment remained significant (r=−0.199, P=0.05), while HRPs lost significance (r=−0.135, P=0.105).
Investigators concluded that foveal involvement in macula-off RRD has a negative impact. Additionally, subretinal HRPs, possibly indicating inflammation, predict poorer visual recovery after surgery.
Source: bjo.bmj.com/content/early/2024/05/05/bjo-2024-325278