Structural recovery of the detached macula after retinal detachment repair as assessed by optical coherence tomography

Korean J Ophthalmol. 2013 Jun;27(3):178-85. doi: 10.3341/kjo.2013.27.3.178. Epub 2013 May 7.


Purpose: To investigate correlations between preoperative and postoperative foveal microstructures in patients with macula-off rhegmatogenous retinal detachment (RRD).

Methods: We reviewed the records of 31 eyes from 31 patients with macula-off RRD who had undergone successful re-attachment surgery. We analyzed data obtained from complete ophthalmologic examinations and optical coherence tomography (OCT) before and 9 to 12 months after surgery. All postoperative OCT measurements were taken with spectral-domain OCT, but a subset of preoperative OCT measurements were taken with time-domain OCT.

Results: The mean duration of macular detachment was 15.5 ± 15.2 days, and mean preoperative best-corrected visual acuity (BCVA, logarithm of the minimum angle of resolution) was 1.03 ± 0.68. Preoperative visual acuity was correlated with retinal detachment height (p < 0.001) and the existence of intraretinal separation (IRS) along with outer layer undulation (OLU) (p = 0.022), but not with macula-off duration. The final BCVA was significantly correlated with integrity of the junction between the photoreceptor inner and outer segments (IS/OS) combined with the continuity of external limiting membrane (ELM) (p = 0.025). The presence of IRS and OLU on a detached macula were highly correlated with the final postoperative integrity of the IS/OS junction and the ELM (p = 0.017).

Conclusions: Eyes preoperatively exhibiting IRS and OLU showed a higher incidence of disruption to the photoreceptor IS/OS junction and the ELM at final follow-up. Such a close correlation between preoperative and postoperative structural changes may explain why ultimate visual recovery in such eyes is poor.

Keywords: Intraretinal layer separation; Junction between the photoreceptor inner and outer segments; Optical coherence tomography; Outer retinal layer undulation; Rhegmatogenous retinal detachment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Fovea Centralis / pathology*
  • Fovea Centralis / surgery*
  • Humans
  • Macula Lutea / pathology
  • Macula Lutea / surgery
  • Male
  • Middle Aged
  • Recovery of Function*
  • Retinal Detachment / pathology*
  • Retinal Detachment / surgery*
  • Retrospective Studies
  • Tomography, Optical Coherence*
  • Young Adult