Anatomical and functional macular changes after rhegmatogenous retinal detachment with macula off

Abstract

Purpose: To evaluate the correlation between morphologic changes in the outer retina and visual function after successful repair of rhegmatogenous retinal detachment with macula off.

Design: Observational case series.

Settings: Dijon University Hospital.

Patients: Thirty patients (30 eyes) with successful repair of rhegmatogenous retinal detachment after macula off and a minimum 6-month follow-up after surgery.

Main outcome measures: Spectral-domain optical coherence tomography (SD-OCT) of the outer retina, fundus autofluorescence (FAF), and microperimetry.

Results: Twenty of 30 eyes presented microstructural changes within the photoreceptor layer (66.7%). Of these, half of the patients (50%) had more than 1 lesion. Disrupted inner segment/outer segment (IS/OS) junction was noted in 16 out of 30 eyes (53.3%), irregular hyporeflectivity in the photoreceptor outer segments (PROS) was observed in 17 eyes (56.7%), external limiting membrane was discontinued in 10 eyes (33.3%), and hyperreflective spots in the outer nuclear layer were observed in 5 eyes (16.7%). FAF changes were detected in only 5 eyes (16.7%). Abnormalities in the IS/OS junction were significantly associated with lower foveal and macular sensitivity, thinner PROS, and global photoreceptor changes (P = .014, P = .003, P = .006, P < .0001, respectively). Patients with a normal foveal profile showed similar findings.

Conclusions: SD-OCT and microperimetry seem to be appropriate tools to determine the visual and the anatomic recovery of the macula after surgery.