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Prognostic Factors for Visual Postsurgical Outcome in Rhegmatogenous Retinal Detachment-A Systematic Review.
George Chereji1, Ovidiu Samoilă2,3, Simona Delia Nicoară1,2,3
1Doctoral School of Medicine, "Iuliu Hat,ieganu" University of Medicine and Pharmacy, 8, V. Babes, Str., 400012 Cluj-Napoca, Romania.
Journal of Clinical Medicine
|March 27, 2025
Summary
Prognostic factors like preoperative vision and symptom duration significantly impact rhegmatogenous retinal detachment (RRD) surgery success. Macular status and retinal tear characteristics are key indicators for visual outcomes after pars plana vitrectomy (PPV).
Area of Science:
- Ophthalmology
- Retinal Surgery
- Medical Diagnostics
Background:
- Rhegmatogenous retinal detachment (RRD) is a critical condition requiring prompt treatment to prevent vision loss.
- Pars plana vitrectomy (PPV) is the primary surgical intervention for complex RRD cases, offering high success rates.
- Patient-specific factors, disease characteristics, and ocular presentation can influence the effectiveness of PPV.
Purpose of the Study:
- To systematically review and synthesize recent scientific literature on prognostic factors influencing the success of PPV in RRD.
- To identify key parameters that affect visual and functional outcomes in patients undergoing RRD surgery.
- To highlight the latest implications of these prognostic factors in managing RRD.
Main Methods:
- A systematic review of studies published between 2010 and 2023 was performed using PubMed/Medline and Scopus.
- Search terms included "prognostic factors," "visual outcome," "functional outcome," and "rhegmatogenous retinal detachment."
- Nineteen articles were selected based on inclusion criteria, including a minimum of 10 participants and a 6-month follow-up, excluding prior PPV or trauma cases. PRISMA guidelines were used for quality assessment.
Main Results:
- Various ophthalmological parameters were evaluated, including refractive error, axial length, lens status, and visual acuity.
- Factors such as symptom duration, RRD extent, and retinal tear characteristics were analyzed.
- Advanced imaging findings, including optical coherence tomography (OCT) results, were also considered.
Conclusions:
- Preoperative best-corrected visual acuity (BCVA), symptom duration, macular status, extent of detachment, macular hole presence, and proliferative vitreoretinopathy (PVR) significantly influenced RRD prognosis.
- Disruption of the ellipsoid zone (EZ), epiretinal membrane (ERM) presence, and external limiting membrane (ELM) integrity loss were linked to poorer surgical outcomes.
- Identifying these prognostic factors is crucial for optimizing surgical planning and patient counseling in RRD management.
