INFLUENCE OF THE BASELINE MORPHOLOGIC STAGE ON POSTOPERATIVE VISUAL ACUITY AND METAMORPHOPSIA OUTCOMES IN FOVEA-OFF...

To evaluate the association between the baseline morphologic stage of rhegmatogenous retinal detachment and postoperative visual acuity and metamorphopsia.

This retrospective study included 39 consecutive patients with primary fovea-off rhegmatogenous retinal detachment who underwent scleral buckling at the Eye and ENT Hospital of Fudan University between 2018 and 2023. Optical coherence tomography, best-corrected visual acuity, and M-CHARTS were assessed at baseline and at 1, 3, 6, and 12 months postoperatively.

Baseline morphologic Stage was 1 and 2 in 41%, 3 in 21%, 4 in 15%, and 5 in 23% of patients. Advanced morphologic stage was associated with worse best-corrected visual acuity ( P = 0.001, 0.001, 0.008, 0.002, and 0.002) and greater M-CHARTS scores ( P = 0.033, 0.004, 0.001, 0.003, and 0.005) at baseline and at 1, 3, 6, and 12 months postoperatively, respectively. After adjusting for covariates, the partial correlation coefficients between best-corrected visual acuity at baseline and at 1, 3, 6, and 12 months postoperatively were significantly positive ( P = 0.001, 0.001, 0.002, and 0.005, respectively), as were the partial correlation coefficients between preoperative vertical M-CHARTS scores and scores at 1, 3, 6, and 12 months postoperatively ( P < 0.001, 0.001, 0.001, and 0.027, respectively). The M-CHART scores at 3, 6, and 12 months were significantly better in Stages 1, 2, and 3 versus Stage 4 ( P = 0.002, 0.003, and 0.002, respectively).

Postoperative best-corrected visual acuity and metamorphopsia deteriorated significantly at all timepoints in patients with more advanced baseline morphologic stages, highlighting the need for earlier intervention in fovea-off rhegmatogenous retinal detachment.