Using optical coherence tomography to evaluate macular changes after surgical management for rhegmatogenous retinal detachment

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. We compared spectral-domain optical coherence tomography imaging with preoperative and postoperative visual acuity to evaluate the relationship between morphological changes in the outer retina and visual outcome after successful repair of RRD with macula on or off. We enrolled 43 patients (43 eyes) with successful repair of RRD and a minimum 6-month follow up after surgery in this retrospective research. Patients accepted spectral-domain optical coherence tomography postoperatively and visual acuity examination preoperatively and postoperatively. The mean age of the patients was 48.74 ± 12.68 years (range: 16–77 years). The mean visual acuity (logarithm of minimal angle of resolution) before surgery was 0.87 ± 0.70. Disrupted ellipsoid zone was noted in one of 11 eyes in the macula-on group (9.1%) and 19 of 32 eyes in the macula-off group (59.4%). Disrupted external limiting membrane (ELM) was noted in no eye in the macula-on group (0%) and 11 of 32 eyes in the macula-off group (34.4%). The macula-off group was associated with better postoperative visual gains than the macula-on group (p = 0.013). 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.