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Importance of subfoveal fluid height on visual outcome in macula-off retinal detachments
  1. Carmen Baumann1,
  2. Ahmed Almarzooqi1,
  3. Navid Johannigmann-Malek1,
  4. Mathias Maier1,
  5. Stephen Kaye2
  1. 1Ophthalmology Department, Hospital rechts der Isar, Technical University of Munich, Munich, Germany
  2. 2Department of Eye and Vision Science, University of Liverpool, Liverpool, UK
  1. Correspondence to Dr Carmen Baumann, Ophthalmology, Technical University of Munich Hospital Rechts der Isar, Munchen 81675, Germany; c.baumann.org{at}gmail.com

Abstract

Aims To investigate the effect of subfoveal fluid height (SFFH) on visual outcome after macula-off retinal detachment (RD) repair.

Methods Prospective interventional case series of consecutive patients undergoing pars plana vitrectomy with gas tamponade (PPV) for primary macula-off RD with duration of symptomatic loss of central vision (LCV) of ≤1 week. Preoperative SFFH was measured on two occasions an hour apart using optical coherence tomography (OCT) by two independent observers. Postoperative best corrected visual acuity (BCVA) was measured at 3 months.

Results Sixty-one patients were included. All patients were pseudophakic after RD repair. The mean preoperative and postoperative BCVA (logarithm of the minimum angle of resolution) at 3 months was 1.41 (±0.71) and 0.15 (±0.12, range 0.00–0.70). Twenty-six patients with SFFH of ≤1500 µm were available for repeat OCT measurements. The variation in SFFH was proportional to the SFFH and showed a logarithmic (base 2) association (r=0.50, p=0.01). Patients were therefore grouped according to their SFFH as group 1: 1–100 µm, group 2: 101–300 µm, group 3: 301–700 µm, group 4: 701–1500 µm and group 5: 1501–3100 µm. BCVA at 3 months significantly reduced with increasing SFFH from 0.04 (±0.03) in group 1 to 0.28 (±0.15) in group 5 (p<0.001) but was not associated with age (p=0.77), preoperative BCVA (p=0.39), duration of LCV (p=0.63) or use of perfluorocarbon liquids (p=0.88). Forty-five patients had SFFH ≤1500 µm and achieved 0.10 (±0.07, range 0.00–0.30) logMAR.

Conclusion Visual acuity following PPV for macula-off RD is related to preoperative SFFH regardless of the duration of symptomatic LCV within the first week.

  • Macula
  • Retina
  • Vision
  • Treatment Surgery

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Footnotes

  • Contributors The study was designed by CB and SK. Data were collected and validated by NJ-M, AA, MM and CB. Analysis of the data was performed by CB and SK. The manuscript was drafted by CB and reviewed by SK. All authors have commented on previous versions and read and agreed to the published version of the manuscript. CB accepts full responsibility for the finished work and the conduct of the study, had access to the data, and controlled the decision to publish.

  • 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 MM reports speaker honoraria from Novartis, Allergan, Bayer, Heidelberg Engineering and Zeiss outside the submitted work. There are no financial disclosures and no conflicting relationship for any of the other authors.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.