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Reductions in final visual acuity occur even within the first 3 days after a macula-off retinal detachment
  1. Margaret A Greven1,
  2. Theodore Leng2,
  3. Ruwan Amila Silva2,
  4. Loh-Shan Bryan Leung2,
  5. Peter A Karth3,
  6. Darius M Moshfeghi2,
  7. Steven R Sanislo2,
  8. Ira H Schachar2
  1. 1 Department of Ophthalmology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
  2. 2 Department of Ophthalmology, Horngren Family Vitreoretinal Center, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California, USA
  3. 3 Oregon Eye Consultants, Eugene, Oregon, USA
  1. Correspondence to Dr Margaret A Greven, Department of Ophthalmology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA; margaret.greven{at}gmail.com

Abstract

Purpose To determine if final visual acuity (VA) is affected by duration of macular detachment (DMD) within the first week of macula-off retinal detachment (RD).

Methods This is a retrospective study of eyes that underwent repair within 7 days with vitrectomy or vitrectomy with scleral buckle for macula-off RD at Stanford University Hospital between 1 May 2007 and 1 May 2017. A generalised linear model was constructed using DMD, postoperative lens status, preoperative VA, patient age and surgeon as the independent variables and the final VA as the dependent variable. The main outcome measure was the final VA.

Results Seventy-nine eyes met the entry criteria. Group 1 included 52 eyes with RD repaired within 3 days of DMD, and group 2 included 27 eyes repaired between 4 and 7 days of DMD. The average final VA in group 1 eyes was logarithm of the minimum angle of resolution (logMAR) 0.21 (Snellen 20/33) and in group 2 eyes was logMAR 0.54 (Snellen 20/69). In group 1 and group 2 eyes, preoperative VA (p=0.017and p=0.007), DMD (p=0.004 and p=0.041) and final lens status (p<0.0001 and p<0.001) predicted postoperative VA. Post-hoc analysis showed significant differences in final VA between detachments of 1day vs 3 days (p=0.0009).

Conclusion DMD affects the final VA even among patients whose DMD is <3 days. Based on these results, interventions that shorten DMD, including those occurring within the first 3days, may result in improved long-term VA outcomes.

  • retina
  • treatment surgery

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Footnotes

  • Contributors Design of the study: MAG, IHS. Conduct of the study: MAG, TL, RAS, L-SBL, PAK, DMM, SRS, IHS. Collection of data: MAG. Management, analysis and interpretation of data: MAG, TL, RAS, L-SBL, PAK, DMM, SRS, IHS. Preparation of manuscript: MAG, TL, RAS, L-SBL, PAK, DMM, SRS, IHS. Review and approval of manuscript: MAG, TL, RAS, L-SBL, PAK, DMM, SRS, IHS.

  • 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 MAG: consultant: Alimera Sciences. TL: consultant: Carl Zeiss Meditec, 23andMe; research grants: Genentech, Allergan, Ohr. RAS: no financial disclosures. L-SBL: consultant: Google. PAK: consultant: Google. DMM: consultant: Alcon, Iconic Therapeutics, Krypton Vision, Visunex; SAB: Allergan; Equity, dSentz, Grand Legend Technologies, PromiSight, Versl, Visunex; Founder/Director: dSentz, PromiSight, Versl. SRS: no financial disclosures. IHS: no financial disclosures.

  • Patient consent for publication Not required.

  • Ethics approval The Stanford University Hospital and Clinics IRB approved the study. Data collection and reporting were in compliance with all Health Insurance Portability and Accountability Act regulations.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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