Preoperative duration of retinal detachment and preoperative central retinal artery hemodynamics: repercussion on visual acuity

Abstract

To analyze if preoperative duration of primary rhegmatogenous retinal detachment (RD) influences preoperative central retinal artery (CRA) hemodynamics with repercussions on logarithmic (LogMAR) visual acuity (VA). Prospective clinical cohort study on 66 healthy patients (33 with proliferative vitreoretinopathy (PVR) and 33 with no PVR) with unilateral RD candidates for scleral buckling (SB) surgery (PVR <C3) as a first and single surgical procedure. CRA Doppler sonography parameters (peak systolic, end diastolic velocities and resistibility index) and IOP were measured before SB. Pearson's correlations were evaluated between preoperative RD duration and each preoperative CRA parameter, and also between both variables and the LogMAR VAs (preoperative, postoperative 8 months, and the difference: postoperative 8 months minus preoperative). Preoperative duration of RD was correlated (with statistical significance both PVR and no PVR) with pre- and postoperative 8 months LogMAR VAs (both positive correlations), with preoperative IOP (negative correlation), and with preoperative CRA parameters (negative correlations with CRA velocities and positive correlation with resistibility index). Preoperative CRA parameters (correlated with preoperative IOP in PVR) were correlated (negatively for CRA velocities and positively for CRA RI) with LogMAR VAs (preoperative, postoperative 8 months, and difference) in PVR. The average preoperative RD duration was longer in the PVR group than in the no PVR group (p < 0.0001). A longer preoperative RD duration was associated with macula-off in both groups. Macula-off and PVR respectively showed lower preoperative IOP and lower preoperative CRA velocities than macula-on and no PVR. Preoperative CRA parameters and LogMAR VAs (pre-, and postoperative 8 months) were influenced by preoperative RD duration in both no PVR and PVR. Preoperative CRA parameters were correlated with LogMAR VAs (pre-, postoperative 8 months, and the difference) only in PVR. Postoperative 8 months and preoperative LogMAR VAs were only correlated (with statistical significance) in macula-on cases of both the PVR and no PVR groups.