Functional and anatomical outcomes after successful repair of macula-off retinal detachment: a 12-month follow-up of the DOREFA study.

Abstract

To report visual and anatomical outcomes and determine predictors of good visual acuity (VA) recovery after macula-off rhegmatogenous retinal detachment (RD). Prospective multicentre study including 115 eyes from 115 patients successfully operated on for RD, with assessment of VA and spectral-domain optical coherence tomography (SD-OCT) macular images at 1, 3, 6 and 12months after surgery. Over the follow-up period, VA significantly improved from median [IQR] 62 [46; 72] ETDRS letters at 1month to 75 [67; 80] ETDRS letters at 12months (p<0.001) with a concomitant decreased number of eyes with any SD-OCT lesions (p<0.001). The presence of subretinal fluid (SRF) significantly decreased (p<0.001), as did the number of photoreceptor (PR) layer lesions (p=0.04). At 12months, lesions in the PR layer and poor VA recovery were significantly associated with a longer time to surgery (p=0.007 and p<0.001, respectively). The rate of patients without PR lesions increased from 40.9% at 1month to 60.0% at 6months and 73.9% at 12months (p<0.001). The incidence of epiretinal membrane (ERM) significantly increased (p<0.001), while cystoid macular oedema (CME) remained stable over time. Visual acuity (VA) at 3months postoperatively was a good reflection of final VA recovery (p<0.001). Visual acuity (VA) improved in parallel with the decreasing number of eyes with SD-OCT lesions after macula-off rhegmatogenous RD. A long time to surgery was the only preoperative factor associated with poor VA recovery after retinal detachment surgery.