Greven M, et al. Br J Ophthalmol. 2018;doi:10.1136/bjophthalmol-2018-313191.
Shorter duration of macular detachment may improve visual acuity
Patients may experience better visual acuity if the duration of macular detachment is shortened to 3 days or less, according to a study conducted by the Department of Ophthalmology at Horngren Family Vitreoretinal Center, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, Calif.
“A number of factors have been identified as predictive of poor visual outcomes, including presenting visual acuity, height of the detachment and duration of macular detachment [DMD],” Margaret A. Greven, MD, of Wake Forest Baptist Health in Winston-Salem, N.C., and colleagues wrote. “For the retinal surgeon, timing of the surgical repair is the only factor that has reliably been shown to affect visual outcomes.”
Researchers conducted a retrospective study of eyes that underwent repair within 1 week of vitrectomy or vitrectomy with scleral buckle for macula-off retinal detachment. The study used a linear model using DMD, postoperative lens status, preoperative visual acuity, patient age and surgeon. The patients were separated into two groups. Group 1 included 52 eyes with retinal detachment repaired within 3 days of DMD, and group 2 included 27 eyes repaired between 4 and 7 days of DMD.
Findings showed the average DMD of patients in group 1 was 2.0 +.09 days, and the average DMD of patients in group 2 was 4.0 +1.5 days. Macula-off detachments of 3 days or less in duration had better visual acuity outcomes than detachments spanning 4 to 7 days in duration. Researchers found that preoperative visual acuity and pseudophakia in the final follow-up with patients was associated with overall better final visual acuity.
“Based on these results, interventions that shorten the duration of the macula-off [retinal detachment], including those occurring within the first 3 days, may result in improved long-term [visual acuity] outcomes,” Greven and colleagues wrote. – by Erin T. Welsh
Disclosures:The authors report no relevant financial disclosures.