Abstract
Background: Retinal detachment is the separation of the neurosensory retina (NSR) from the underlying retinal pigment epithelium (RPE). These two layers are derived from neuroectoderm that lines the optic vesicle during embryogenesis. Objective: We compared spectral-domain optical coherence tomography imaging with postoperative visual acuity to evaluate the relationship between morphological changes in the macula and visual outcome after successful repair of RRD with macula off. Patients and methods: We enrolled 30 patients (30 eyes) 21 eyes were phakic (70%) and 9 eyes were pseudophakic (30%). with successful repair of RRD. the examination had been done 1,2,6-months and one year follow up after surgery in this prospective research. The mean age of the patients was 17 to 73 years with mean age value of 44 ± 13.4 years. The duration of retinal detachment (RD) ranged from 1 to 14 weeks with a mean of 6.8± 4.2 weeks. There was history of trauma in 3 cases (10%). The IS/OS line was evaluated considering its continuity and any disruption in the line was measured by manual caliber. The extent of disruption was evaluated in the 5-lines raster scan. In the scan that showed the largest defect, the extent of the IS/OS disruption was measured along a 1.8 mm-diameter area centered on the fovea. Results: SD-OCT was done to all patients post-operatively according to OCT findings, the 30 eyes were divided into three groups; A, B, and C. Group A included all cases with residual subretinal fluid, Group B included cases with other finding rather residual subretinal fluids. Group C included eyes with no detectable OCT findings. There were 8 (26.7%) eyes with retained subretinal fluids (Group A), 18 eyes (60%) with pathology other than Subretinal fluid (Group B), and 4 eyes (13.33%) with no detectable pathology after the operation (Group C) Conclusion: SD-OCT is an irreplaceable instrument for the postoperative assessment of macula in patients who have undergone surgery for macula-off RRD. It permits detection of the presence of foveal changes that are not visible with ophthalmoscope. Persistent sub-retinal fluid is responsible for the poor prognosis after surgery. Although there was a detectable improvement in vision with decrease of the amount of subretinal fluid, Visual prognosis related to other pathological finding as photoreceptors integrity, and presence or absence of Cystoid macular edema.
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