MAR 06, 2023
Retina/Vitreous
The most successful retinal detachment repairs appear to be seen when the duration of the macular detachment is no more than 2 days, although repairing within 3 days still yields a significantly better prognosis than waiting 4 days or longer.
Study design
This prospective observational cohort study sought to determine if there is a correlation between the duration of macular detachment (DMD) and visual outcomes after rhegmatogenous retinal detachment (RRD) repair. A total of 719 eyes with macula-off RRD according to the Japan-Retinal Detachment Registry were included. Outcomes were compared 6 months postoperatively using BCVA as a primary measure.
Outcomes
Six months after surgery, BCVA was significantly better in patients whose retinal detachment repair occurred within 2 days of macular detachment onset as compared to those whose macular detachment lasted 3 days or longer (P = 9.1 × 10–7). A similar result was found if the DMD was 3 days or less in comparison to 4 days or more (P = 1.6 × 10–3).
Limitations
Macular detachment onset was based on the patient's complaint and therefore is an imprecise measure that may have introduced bias. In addition, some patients had a prior history of vitrectomy, including for retinal detachment; this may cloud the results, as there was no mention of macular status prior to the initial surgery for eyes that had been previously vitrectomized.
Clinical significance
Retinal repair within 2 days of macular detachment appears to yield the best BCVA at 6 months, followed by repair within 3 days of detachment. However, when the DMD is greater than 4 days, the timing of surgical intervention does not seem to significantly impact visual prognosis. These results suggest that prompt surgery after the onset of macular detachment is important to achieve more positive outcomes, so attempts should be made to intervene sooner in these macula-off cases.
Financial Disclosures: Dr. Marianeli Rodriguez discloses no financial relationships.