Elsevier

Ophthalmology

Volume 112, Issue 7, July 2005, Pages 1213-1217
Ophthalmology

Original Article
The Correlation between Height of Macular Detachment and Visual Outcome in Macula-Off Retinal Detachments of ≤7 Days’ Duration

Presented at: Society of American Retinal Specialists Annual Meeting, August, 2004; San Diego, California, and Retina Society meeting, October, 2004; Baltimore, Maryland.
https://doi.org/10.1016/j.ophtha.2005.01.040Get rights and content

Objective

To determine the relationship between the height of macular detachment and visual recovery after treatment of macula-off retinal detachments (RDs) of ≤7 days’ duration.

Design

Prospective comparative case series.

Participants

Fifty-two eyes of 52 consecutive patients who presented to one institution with macula-off RDs of ≤7 days’ duration were prospectively enrolled in the study.

Methods

Gender, age, lens status, duration of macular detachment, and presenting visual acuity (VA) were recorded for all patients. Each patient underwent a 3-dimensional B-scan ultrasound examination at the time of presentation. The height of macular detachment was calculated using the mean measured distance between the retinal pigment epithelium and the outer neurosensory retina 3, 4, and 5 mm temporal to the center of the optic nerve head. All patients underwent primarily successful reattachment surgery within 7 days of macular detachment. Final vision was recorded with a minimum of 6 months’ follow-up.

Main Outcome Measure

Postoperative VA evaluated as a continuous variable.

Results

For the 52 subjects, a direct correlation between lower height of macular detachment and better final postoperative vision (dependent variable) was observed with linear regression (slope, 0.114; 95% confidence interval, 0.022–0.206; P = 0.016). Multivariate linear regression analysis with a backward stepwise approach did not demonstrate any significant association between postoperative vision and predictor variables (gender, age, lens status, duration of macular detachment, macular height, and preoperative vision), except for macular height.

Conclusion

Lower height of macular detachment correlates with better visual recovery after treatment of macula-off RDs of ≤7 days’ duration.

Section snippets

Patients and Methods

This prospective study reviewed 52 patients with macula-off RDs who underwent successful reattachment surgery within 1 week of macular involvement. The study was conducted over an 18-month period (May 1, 2002–November 1, 2003). Internal review board ethics approval was obtained for the study. All patients were interviewed and underwent a full ocular evaluation. The following data were collected for each patient: age, gender, preoperative Snellen and logarithm of the minimum angle of resolution

Results

A total of 52 patients were found to have a primary rhegmatogenous detachment for which the patient could accurately determine the onset of macular detachment and the detachment fulfilled the inclusion criteria outlined above. The age of patients ranged from 14.1 to 85.5 years, with a mean age of 60.5 years. There were 36 (69.2%) male and 16 (30.8%) female patients. There were 30 (57.7%) right eyes and 22 (42.3%) left eyes. Twenty-six (50%) were phakic, and 26 (50%) were pseudophakic. The mean

Discussion

In 1998, Ross and Kozy reported a series of 104 patients with macula-off RD of ≤7 days duration.13 All patients underwent scleral buckling surgery within 24 hours of presentation. Fifty nine percent of patients regained 20/50 or better vision, 25% regained VA between 20/60 and 20/200, and 5% of patients were left with VA of less than 20/200. There was no statistical difference in visual recovery in patients operated within 1 to 2 days, 3 to 5 days, or 5 to 7 days after macular involvement (P =

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Manuscript no. 240552.

The authors have no financial interest in any device or technology used in the study.

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