PERSISTENT SUBFOVEAL FLUID AND INCREASED PREOPERATIVE FOVEAL THICKNESS IMPAIR VISUAL OUTCOME AFTER MACULA-OFF RETINAL DETACHMENT REPAIR.
Ricker, Lukas J A G MD *+; Noordzij, Leo J MD *; Goezinne, Fleur MD *; Cals, Diana W J K MD *; Berendschot, Tos T J M PhD *; Liem, Albert T A MD, PhD *; Hendrikse, Fred MD, PhD *; La Heij, Ellen C MD, PhD *
[Article] Retina. 31(8):1505-1512, September 2011.

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Purpose: To investigate the influence of subfoveal fluid and foveal thickness on visual outcome in patients who underwent reattachment surgery for rhegmatogenous retinal detachment (RRD).

Methods: This prospective study included 53 patients who were undergoing successful scleral buckling surgery for primary RRD. A thorough ophthalmologic examination including best-corrected visual acuity, slit-lamp biomicroscopy, binocular indirect ophthalmoscopy, and optical coherence tomography scanning was performed preoperatively and during all subsequent follow-up visits at 1, 3, 6, 9, 12, and 24 months postoperatively.

Results: Preoperative foveal thickness was significantly higher in the macula-off group (n = 38) compared with the macula-on group (n = 15) (P < 0.0001), whereas postoperative measurements were normal in both the groups. Linear mixed-model analysis revealed that persistent subfoveal fluid (P = 0.0004) was an independent predictor of a worse visual outcome after scleral buckling surgery for primary macula-off RRD, although the effect on visual outcome was small (0.1 logarithm of the minimal angle of resolution units). Moreover, increased preoperative foveal thickness was associated with a worse visual prognosis in macula-off RRD (P = 0.010).

Conclusion: Persistent subfoveal fluid and increased preoperative foveal thickness were associated with a worse visual prognosis in macula-off RRD patients, albeit the effect of persistent subfoveal fluid was small and temporary.

(C) The Ophthalmic Communications Society, Inc.