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Long-term visual acuity and the duration of macular detachment: findings from a prospective population-based study
  1. Danny Mitry1,2,
  2. Muhammad Amer Awan3,
  3. Shyamanga Borooah1,
  4. Andreas Syrogiannis4,
  5. Charles Lim-Fat5,
  6. Harry Campbell2,
  7. Alan F Wright1,
  8. Brian W Fleck1,2,
  9. David G Charteris6,
  10. David Yorston3,
  11. Jaswinder Singh1
  1. 1Department of Ophthalmology, Princess Alexandra Eye Pavilion, Edinburgh, UK
  2. 2Department of Public Health Sciences, University of Edinburgh, Teviot Place, UK
  3. 3Department of Vitreoretinal surgery, Gartnavel General Hospital, Glasgow, UK
  4. 4Department of Ophthalmology, Ninewells Hospital, Dundee, UK
  5. 5Department of Ophthalmology, Raigmore General Hospital, Inverness, UK
  6. 6Department of Vitreoretinal surgery, Moorfields Eye Hospital, London, UK
  1. Correspondence to Dr Danny Mitry, Department of Ophthalmology and Public Health Sciences, University of Edinburgh, Teviot Place, Edinburgh EH3 9HA, UK.; mitryd{at}gmail.com

Abstract

Aim To report the long-term visual outcome of a multicentre prospectively recruited cohort of macula-off rhegmatogenous retinal detachments (RRD)

Methods The Scottish retinal detachment study was a prospectively recruited study that recruited all incident cases of primary RRD in Scotland over a 2-year period (2007–2009). All patients with a macula-off RRD from four participating sites were invited for clinical examination at 6 weeks, 3 months, 6 months and 1 year after the initial surgery. Using a joinpoint model we estimated the effect of duration of macular detachment on final visual outcome.

Results In total, there were 291 patients with macula-off RRD without pre-existing retinal disease who had successful repair after one operation. 65.9% achieved a final visual acuity (VA) of 0.48 logMAR(6/18). Our model identified two time points (day 8 (95% CI 3 to 15 days) and (day 21 (95% CI 6 to 26 days)) after which there was a statistically significant worsening in final VA.

Conclusions Our study suggests that the majority of patients with macula-off RRD successfully repaired with one operation will achieve a VA of 6/18 or better at final follow-up. After 8 days of macular detachment, the final visual outcome may be adversely affected and, thus, operative repair within this period is desirable. Duration of macular detachment of ≤8 days demonstrated a continuing improvement in VA for up to 1 year, a finding which was not found in macula detachments of longer duration.

  • Retina
  • Epidemiology
  • Vision

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