Comparison of the visual outcome between macula-on and macula-off rhegmatogenous retinal detachment based on the duration of macular detachment

Objective To compare the visual outcomes between macula-on and macula-off primary rhegmatogenous retinal detachment (RRD) based on the duration of macular detachment (DMD). Methods and Analysis Retrospective study including 96 eyes with RRD (34 macula-on and 62 macula-off) repaired between June 2012 and March 2020. The final visual acuity (VA) was compared after the patients were divided by the status of the macula and their DMD. Results The mean final VA of patients with macula-on RRD (group A) was logarithm of the minimum angle of resolution (logMAR) 0.04 +/- 0.07, which was not statistically different from that of individuals with macula-off RRD with DMD <= 3 days (group B; logMAR 0.05 +/- 0.06) (p=0.79). There were statistically significant differences in the final VA between group A and patients with macula-off RRD with DMD of 4-7 days (group C; logMAR 0.15 +/- 0.15) (p=0.017) as well as between group A and those with macula-off RRD with DMD >= 8 days (group D; logMAR 0.36 +/- 0.29) (p<0.001). There was no significant difference in the final VA between group B and C (p=0.33). Conclusion The mean final VA of patients with macula-on RRD was comparable to that of the macula-off patients with DMD <= 3 days. Our findings suggest that if macula-on RRD could not be immediately repaired, a repair within 72 hours may result in similar outcomes, even if the macula detaches within that time frame. However, once the macula detaches, we do not observe statistically significant differences in outcome for repairs done within 7 days.