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  • Visual Decline Linked to Photoreceptor Loss After RRD Repair

    By Lynda Seminara
    Selected by Prem S. Subramanian, MD, PhD
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    Journal Highlights

    Graefe’s Archive for Clinical and Experimental Ophthalmology
    Published online Jan. 26, 2022

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    After retinal reattachment surgery, retinal function is impeded by synap­tic connectivity changes in the outer plexiform layer, imperfect photorecep­tor regeneration, retinal scarring, and other alterations. In a prospective study to better understand the relationship between photoreceptor function and vision, Rasool et al. found that photo­receptor degeneration correlated with poorer visual outcomes.

    The study consisted of 21 patients who underwent reattachment surgery (13 macula-off, eight macula-on) for rhegmatogenous retinal detachment (RRD). Each patient was examined before surgery and six months postop­eratively. Assessments included OCT measurements of the outer nuclear layer (ONL), outer retinal segment (ORS), retinal pigment epithelium-to-ellipsoid zone (RPE-EZ), and exter­nal limiting membrane to EZ (ELM-EZ). Findings were compared with those for BCVA and retinal sensitivity.

    Six months after reattachment sur­gery, the ONL was thicker in macula-on cases (97.70 ± 3.62 μm) than in macula-off cases (73.10 ± 4.98 μm). Overall, each 1-μm decrease in ONL and ORS thickness coincided with 0.052-dB and 0.062-dB decreases, respectively, in retinal sensitivity. ORS, ELM-EZ, and RPE-EZ measurements were unrelated to post-op BCVA. The duration of retinal detachment before reattachment surgery did not affect BCVA, ONL thickness, or retinal sensi­tivity six months after the surgery.

    The association of ONL thickness with retinal sensitivity and visual acuity supports the notion that photoreceptor apoptosis after macula-off RRD contributes to reduced visual function. The link between ORS thickness and retinal sensitivity emphasizes the importance of recovering inner and outer photo­receptor function after reattachment surgery, said the authors. They added that “correlations between ONL and ORS thinning with decreased retinal sensitivity may be explained by RRD-induced photoreceptor death.”

    The original article can be found here.