Imaging Predictors of Functional Outcomes after Rhegmatogenous Retinal Detachment Repair.

Abstract

Purpose: To evaluate the microstructural optical coherence tomography (OCT) and fundus autofluorescence (FAF) imaging predictors of visual acuity, metamorphopsia and aniseikonia following rhegmatogenous retinal detachment (RRD) repair. Methods: Multicenter retrospective study of patients with primary RRD who underwent repair. Best corrected visual acuity, metamorphopsia and aniseikonia were formally tested at 3 months post-operatively. Metamorphopsia and aniseikonia were quantitatively assessed with M-CHARTS and the New Aniseikonia Test, respectively. High-resolution spectral-domain OCT and FAF images were obtained at 3 months post-operatively. Images were assessed for discontinuity of the outer retinal bands on OCT and retinal displacement detected by retinal vessel printings (RVPs) on FAF by 2 masked graders with disagreements adjudicated by a 3rd senior masked grader. Multiple linear regression models were used to determine the predictors of post-operative visual acuity, metamorphopsia and aniseikonia. Results: 614 eyes of 614 patients were included in the study. Regression analysis indicated that significant early post-operative (at 3 months) imaging predictors of visual acuity were discontinuity of the external limiting membrane (ELM) (p=0.001) and presence of RVPs on FAF (p=0.033). Discontinuity of interdigitation zone (IZ) was a significant predictor of metamorphopsia [horizontal, MH (p =0.004); vertical, MV (p=0.056); average of MH+MV (p=0.008)] and presence of RVPs was a significant predictor of aniseikonia (p=0.04). Conclusions: Discontinuity of the ELM and retinal displacement were significant predictors of post-operative visual acuity following RRD repair. Discontinuity of the IZ and retinal displacement were significant predictors of metamorphopsia and aniseikonia, respectively.