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OCT analysis of preoperative foveal microstructure in recent-onset macula-off rhegmatogenous retinal detachment: visual acuity prognostic factors
  1. Maria Cristina Savastano1,2,
  2. Matteo Mario Carlà1,2,
  3. Federico Giannuzzi1,2,
  4. Claudia Fossataro1,2,
  5. Valentina Cestrone1,2,
  6. Francesco Boselli1,2,
  7. Ilaria Biagini1,2,
  8. Flavia Beccia3,
  9. Quatrale Raffaele2,
  10. Gianni Gravina1,2,
  11. Clara Rizzo4,
  12. Alfonso Savastano1,2,
  13. Stanislao Rizzo1,2,5
  1. 1“Fondazione Policlinico Universitario A Gemelli IRCCS”, Rome, Italy
  2. 2Catholic University “Sacro Cuore”, Rome, Italy
  3. 3Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Milano, Italy
  4. 4Ophthalmology, University of Verona, Verona, Italy
  5. 5Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, Pisa, Italy
  1. Correspondence to Dr Matteo Mario Carlà, Ophthalmology Department, Università Cattolica del Sacro Cuore Scuole di Specializzazione, Roma, Lazio, Italy; mm.carla94{at}gmail.com

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.

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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.