IMPACT OF FOVEAL STATUS AND TIMING OF SURGERY ON VISUAL OUTCOME IN RHEGMATOGENOUS RETINAL DETACHMENT

Area of Science:

• Ophthalmology
• Retinal Surgery
• Visual Outcomes

Background:

• Retinal detachment (RD) is a serious condition requiring timely intervention.
• Preoperative foveal status is a key prognostic factor in RD surgery.
• Understanding the impact of surgical timing based on foveal involvement is critical for patient management.

Purpose of the Study:

• To investigate the impact of surgical timing on visual acuity (VA) outcomes in retinal detachments.
• To analyze these outcomes based on preoperative foveal status: fovea-on, fovea-split, and fovea-off.

Main Methods:

• Retrospective multicenter cohort study of 1,675 retinal detachment cases.
• Stratification into fovea-on, fovea-split, and fovea-off groups.
• Analysis of final postoperative visual acuity in relation to days to surgery.

Main Results:

• Fovea-on and fovea-split RD groups showed comparable final visual acuity (SE 20/33 and 20/32, respectively).
• Surgical timing did not significantly impact VA in fovea-on/split groups.
• Fovea-off RD group had the lowest VA (SE 20/56), with significantly worse outcomes when surgery was delayed beyond two days (SE 20/74 vs. 20/46).

Conclusions:

• Retinal detachments with foveal involvement (fovea-on/split) yield similar visual outcomes.
• Fovea-off retinal detachments have poorer visual outcomes.
• Delaying surgery for fovea-off RDs by two or more days further diminishes visual acuity outcomes.