Article Text
Abstract
Background To evaluate, in patients undergoing macula-off rhegmatogenous retinal detachment surgery (RRD), the correlation between preoperative optical coherence tomography (OCT) morphological features and postoperative visual acuity.
Methods Retrospective interventional non-randomised clinical trial on 89 eyes of 89 patients undergoing pars plana vitrectomy for macula-off primary RRD at Policlinico Universitario Agostino Gemelli from 2020 to 2023. Preoperative 6×6 mm OCT B scans with Nidek Mirante (Nidek, Gamagori, Japan) were performed, collecting the following features: foveal involvement (fovea-on vs fovea-off), subretinal hyper-reflective points (HRPs), outer retinal corrugations (ORCs) and intraretinal cystic spaces (ICS) in the outer nuclear layer. The patients were followed in a 6-month follow-up to evaluate best-corrected visual acuity (BCVA) outcomes.
Results Preoperative mean BCVA was 0.15±0.22 and improved to 0.29±0.3 decimals at 6 months (p<0.001). The presence of subretinal HRPs showed a significant negative impact on BCVA improvement in the univariate regression analysis (r=−0.264, p=0.024), as well as the presence of foveal detachment (r=−0.355, p=0.012). The other OCT features did not show a significant correlation with BCVA improvement: ORCs (r=0.072, p=0.257) and ICS (r=−0.020, p=0.734). In the multivariate regression analysis, the negative impact of foveal detachment was confirmed (r=−0.199, p=0.05) while the statistical significance of subretinal HRPs was lost (r=−0.135, p=0.105).
Conclusions The negative impact of foveal involvement in a macula-off RRD was confirmed. Moreover, the presence of subretinal HRPs, as a possible indirect marker of inflammatory response extent, may act as a negative predictor for postoperative visual recover.
Trial registration number NCT05747144.
- Retina
- Ophthalmologic Surgical Procedures
- Imaging
- Vitreous
Data availability statement
Data are available on reasonable request.
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Data availability statement
Data are available on reasonable request.
Footnotes
MCS and MMC are joint first authors.
Contributors Collection: IB, VC and QR; Writing paper: MMC; Idea of paper investigation: MCS and SR; Review: FG, CF, FB and GG; Statistical analysis: FB and MMC; Supervision: AS and SR; Guarantor: SR.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.