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RESEARCH PRODUCT

Functional and anatomical outcomes after successful macula-off retinal detachment surgery, a 12 month-follow-up

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This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.; Purpose: To describe the changes of retinal structure and function after successful repair of macula-off rhegmatogenous retinal detachment (RRD). Methods: Prospective multicenter study including patients with successful surgery for macula-off RRD between October 2011 and April 2014. Those with pre-existing macular diseases or with surgery failures were excluded. Each patient underwent a complete ophthalmologic exam at baseline and at 1, 3, 6 and 12 months after the surgery (M1, M3, M6, M12, respectively). Function was assessed by measuring the best-corrected visual acuity (BCVA) at 4 m using the standard Early Treatment Diabetic Retinopathy Study chart, and structure was evaluated by Spectral-Domain Optical Coherence Tomography (SD-OCT) macular imaging. In two of the involved centers, microperimetry examinations were performed at M6 and M12. Results: One hundred and fifteen eyes of 115 patients from ten French centers. Median [IQR] age was 63 [57 ; 69] years. The median BCVA increased significantly from 62 [48 ; 72] letters at M1 to 75 [68 ; 80] letters at M12, p < 0.047. Irregular hyporeflectivity of the photoreceptor outer segments (PROS) and disruption of the ellipsoid line decreased significantly between M1 and M12, 59.1% vs 28.6%, p < 0.001 and 27.0% vs 10.7%, p = 0.006, respectively. In contrast, the restoration of the outer limiting membrane and the subretinal fluid resorption were not significantly improved between M1 and M12, p = 0.885 and p = 0.999, respectively. The number of eyes without any macular lesions on SD-OCT significantly increased between M1 and M12, 29.6% vs 56.2%, p < 0.001. Among the 38 patients who had a microperimetry examination, median macular and foveal sensitivities did not change between M6 and M12, p = 0.694 and p = 0.697, respectively. Only macular sensitivity at M12 was significantly higher in the group without any lesion on SD-OCT (p = 0.044). Conclusions: A better knowledge of functional and anatomical kinetics after macula-off RRD constitutes a preliminary step for studying factors influencing the visual prognosis and the evaluation of future therapies aimed at preventing long-term retinal damage after RRD.