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  • Meta-Analysis of Preoperative OCT Features in RDs

    By Jean Shaw
    Selected by Andrew P. Schachat, MD
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    Journal Highlights

    Ophthalmology Retina, May 2023

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    Murtaza et al. set out to evaluate the prognostic relationship between preoperative features of retinal detach­ments (RDs) as noted on OCT scans and postoperative visual outcomes. They found that four features—greater height of retinal detachment (HRD), disruption of the ellipsoid zone (EZ) and/or the external limiting membrane (ELM), presence of intraretinal cystic cavities (ICCs), and macular detach­ment—were associated with poor visual recovery and post-op VA, although the quality of the evidence was low. They also proposed a standardized nomen­clature for reporting preoperative RD OCT features for future studies.

    For this meta-analysis, the research­ers extracted data from 29 studies. All told, 1,670 patients (1,671 eyes) were included in the analysis. The primary outcome was the association between six preoperative OCT findings in RDs and postoperative VA. The participants’ average age was 55 ± 6.42 years. At baseline, 89.4% of eyes had a macula-off RD, and 80.3% had a primary RD. The average duration of detachment was 15.1 ± 9.9 days, and the average duration of follow-up after surgery was 15.4 ± 9.8 months (range, 1-30 months). Most eyes (62%) underwent pars plana vitrectomy.

    Two features—outer retinal corru­gations and central macular thickness (CMT)—had no bearing on post-op VA. A greater HRD at the fovea was only weakly associated with a poorer postoperative VA. Preoperative dis­ruption of the EZ and/or ELM, the presence of ICCs, and the presence of macular detachment were significantly associated with poor post-op VA, rang­ing from a difference of 2 to 3 Snellen lines. All associations had a low quality of evidence, with CMT being of very low quality.

    Because of inconsistencies in the literature regarding the classification and measurement of OCT features, the authors also proposed a nomenclature and classification system for common pre-op features seen on OCT in RDs. This system is meant to “guide and promote consistency in future studies,” the authors wrote.

    The original article can be found here.