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Purpose: A comparative study using OCT to determine the possible causes associated withincomplete visual recovery after successful rhegmatogenous retinal detachment (RRD) repair incases with and without visual improvement. Patients& methods: We studied 200 eyes of 200patients with RRD that involved the fovea. The patients were examined and the findingsrecorded before and after surgery. The period from the onset of symptoms to presentationranged from 3-60 days. OCT was performed at the 1st, 3rd, and 6th post-operative months. Thepatients were followed for a period from 6-18 months (mean 8.4 months). Results: On comparingthe best corrected visual acuities (BCVAs) at 1st and 6th months, there was a mean gain of 3Snellen lines (range; 1-6 lines) in 160 patients (80%) and no improvement in 40 patients(20%).The mean postoperative BCVA at 1,3 and 6 months of the improved patients was 6/60,6/24,and 6/18 respectively (Log MAR equivalent of 1.00, 0.60 ,and 0.50 ). OCT of these 40 eyeswithout visual improvement showed subfoveal fluid in 10 eyes (25%), macular edema(ME) in 21(52.5%) eyes, epiretinal membranes(ERM) in 15 eyes (37.5%), photoreceptor damage (distortion ofthe photoreceptors IS/OS junction in 31 eyes (77.5%), macular holes(MH) in 2 eyes (5%), andretinal pigment epithelium (RPE) degenerative changes in 11 eyes (27.5%). OCT of those withvisual improvement also showed some abnormalities which contributed to incomplete visualrecovery: ME in 21 eyes (13.2%), ERM in 9 (5.6%)eyes, subfoveal fluid in 40 eyes (25%),photoreceptor damage in 31 eyes (19.4%), and RPE degenerative changes in 12 eyes (7.5%).Conclusion: Incomplete and/or delayed visual recovery after successful retinal reattachment mayoccur even in cases with visual improvement due to many causes; photoreceptor damage, macularedema, epiretinal membranes, subfoveal fluid, macular holes, and RPE degenerative changes.OCT is a valuable and noninvasive tool for detecting, evaluating and follow-up of these cases. |
