Predictive visual outcome after macula-off retinal detachment surgery using optical coherence tomography

Purpose: To determine whether preoperative optical coherence tomography (OCT) is useful in predicting postoperative visual outcome for patients with primary macula-off rhegmatogenous retinal detachment (RD). Methods: This prospective study included 20 nonconsecutive eyes with macula-off RD and successful reattachment of the retina. Preoperative 5-mm OCT was performed through the center of the fovea. The relationship among preoperative OCT findings, main preoperative clinical variables, and final postoperative visual acuity was statistically analyzed. Results: Final postoperative visual acuity was negatively correlated with three preoperative OCT variables: height of RD at the central fovea (r = 0.79; P < 0.001), distance from the central fovea to the nearest undetached retina (r = 0.75; P < 0.00051), and, to a lesser degree, extent of structural changes in the detached retina (r = 0.48; P = 0.03). Preoperative visual acuity was the only clinical variable statistically correlated with final postoperative visual acuity in this study (r = 0.55; P = 0.01). Using multivariate logistic regression analyses, the structure of the detached retina combined with the distance from the central fovea to the nearest undetached retina, as determined with OCT, was highly correlated with final postoperative visual acuity (r = 0.82; P < 0.000051). Conclusion: Preoperative macular analysis with OCT may help to predict visual outcome for patients with macula-off RD.