Prevalence and risk factors for outer retinal layer damage after macula-off retinal detachment

Area of Science:

• Ophthalmology
• Retinal Surgery
• Optical Coherence Tomography

Background:

• Macula-off rhegmatogenous retinal detachment (RRD) can lead to photoreceptor damage.
• Assessing outer retinal layer (ORL) integrity is crucial for understanding visual prognosis after RRD surgery.

Purpose of the Study:

• To determine the prevalence of outer retinal layer (ORL) damage following macula-off RRD surgery.
• To identify preoperative risk factors associated with ORL damage.
• To evaluate the correlation between ORL integrity and visual outcomes.

Main Methods:

• Spectral-domain optical coherence tomography (SD-OCT) was used to assess the integrity of the external limiting membrane (ELM), ellipsoid zone (EZ), and cone interdigitation zone (CIZ) in 253 eyes.
• Risk factors were analyzed using univariate and multivariate logistic regression.
• Correlation between ORL integrity and visual outcomes was evaluated at 1 and 6 months post-surgery.

Main Results:

• High prevalence of ORL defects (CIZ, EZ, ELM) was observed at 1 month, significantly decreasing by 6 months.
• Longer duration of macular detachment was the only significant risk factor for ORL damage at 6 months.
• Best-corrected visual acuity improved significantly from 1 to 6 months and strongly correlated with the number of unaffected ORL bands.

Conclusions:

• Outer retinal layer defects show substantial improvement over 6 months, indicating photoreceptor recovery potential.
• Shorter interval to surgery and better visual outcomes are linked to fewer ORL defects at 6 months.
• Earlier surgical intervention for RRD may mitigate photoreceptor degeneration and enhance visual prognosis.