EVALUATION OF THE MACULAR CHANGES AFTER SUCCESSFUL RETINAL DETACHMENT SURGERY USING OPTICAL COHERENCE TOMOGRAPHY

Mansour Hassan Ahmed*, Mohamed Yasser Sayed Saif, Bahaa Abdallah Hassan, Sherif Momtaz Hegazy and Mohamed Sayed Taha

ABSTRACT

Background: Incomplete visual recovery, color vision defects, or persistent metamorphopsia may persist even
after successful surgery for rhegmatogenous retinal detachment (RRD), especially in cases of RD with macula off,
suggesting microstructural macular damage that standard fundus biomicroscopy could not detect. Methods: We
compared swept-source optical coherence tomography imaging with preoperative and postoperative visual acuity to
evaluate the relationship between morphological changes in the outer retina and visual outcome and also to detect
the changes in the subfoveal choroid thickness after successful repair of RRD with macula off. We enrolled 40
patients (40 eyes) with successful repair of RRD. The mean postoperative follow-up duration at the time of the
initial and the final swept-source optical coherence tomography scan was 1.6 and 5.7 months respectively. Results:
The mean age of the patients was 59.2± 13.4 years (range: 24-82 years). The mean visual acuity (logarithm of
minimal angle of resolution) before surgery was 1.14± 0.64. Disrupted ellipsoid zone was noted in 17 eyes
(42.5%). Disrupted external limiting membrane (ELM) was noted in 4 eyes (10%). The mean postoperative visual
acuity was 0.85± 0.56. The difference between the visual acuity before and after surgery was statistically
significant. Patients with integrity of the ellipsoid zone and ELM were associated with significant visual
improvement than patients with disruption of the ellipsoid zone or ELM. There were no statistically significant
differences in the mean subfoveal choroidal thickness between the fellow eyes and the operated eyes at the initial
and the final swept-source optical coherence tomography scan. Conclusion: the presence of ellipsoid zone or
external limiting membrane disruptions seems to correlate with visual acuity outcome after rhegmatogenous retinal
detachment repair. The presence of subretinal fluid on the early postoperative swept-source optical coherence
tomography images may lead to transient decrease in visual acuity, but subretinal fluid usually seems to resolve
spontaneously with long-term follow-up. Retinal detachment surgeries don’t affect the subfoveal choroidal
thickness.

Keywords: Ellipsoid zone; External limiting membrane; Swept-source optical coherence tomography; Macula off rhegmatogenous retinal detachment; Subfoveal choroidal thickness.