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Clinical science
Prevalence and risk factors for outer retinal layer damage after macula-off retinal detachment
  1. Laure Malosse1,
  2. Hélène Rousseau2,
  3. Cédric Baumann2,
  4. Karine Angioi1,
  5. Bertrand Leroy1,
  6. Florian Sennlaub3,
  7. Jean-Paul Berrod1,
  8. Jean-Baptiste Conart1
  1. 1 Department of Ophthalmology, University Hospital Centre Nancy, Nancy, France
  2. 2 ESPRI-BioBase Unit, Platform of PARC, Nancy University Hospital, Vandoeuvre-lès-Nancy, France
  3. 3 Institut de la Vision, 17 rue Moreau, Sorbonne Universités, UPMC Univ Paris 06, INSERM, CNRS, Paris, France
  1. Correspondence to Dr Jean-Baptiste Conart, Ophthalmology, University Hospital Centre Nancy, Nancy, France; jbconart{at}hotmail.com

Abstract

Purpose To report the prevalence of outer retinal layer (ORL) damage after macula-off rhegmatogenous retinal detachment (RRD) surgery and to determine its associated preoperative risk factors.

Methods 253 eyes successfully operated for macula-off RRD were included in the study. The integrity of the external limiting membrane (ELM), ellipsoid zone (EZ) and cone interdigitation zone (CIZ) of the photoreceptors was assessed at 1 month and 6 months using spectral-domain optical coherence tomography. Risk factors were analysed using univariate and multivariate logistic regression. The correlation between ORL integrity and visual outcomes was also evaluated.

Results CIZ, EZ and ELM defects were found in, respectively, 198 (93.4%) eyes, 100 (47.2%) eyes, 64 (30.2%) eyes at 1 month and in 160 (63.2%) eyes, 44 (17.4%) eyes and 18 (7.1%) eyes at 6 months. In multivariate analysis, duration of macular detachment was the only factor associated with ORL damage at 6 months (p=0.007). Best-corrected visual acuity significantly improved from 0.5±0.3 at 1 month to 0.3±0.3 logarithm of minimal angle of resolution at 6 months (p<0.001) and was strongly correlated with the number of affected bands (p<0.001).

Conclusion Prevalence of outer retinal band defects substantially decreased through the study period, confirming the ability of photoreceptors to recover over time. However, shorter interval to surgery and better visual outcomes were significantly associated with fewer defects within the ORL at 6 months. These findings suggest that earlier surgery may limit RRD-associated photoreceptor degeneration and improve the patient’s visual prognosis.

  • imaging
  • retina
  • macula
  • treatment surgery

https://doi.org/10.1136/bjophthalmol-2019-314236

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    Footnotes

    • Contributors Substantial contributions to conception and design: LM, JBC, HR, CB and JPB; acquisition of data: LM and JBC; writing the statistical analysis plan: HR and CB; analysis and interpretation of data: LM, JBC, HR, CB and BL; drafting the article: LM and JBC; revising it critically for important intellectual content: JPB, KAD and FS; and final approval of the version to be published: all authors.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval The study adhered to the tenets of the Declaration of Helsinki and the protocol was approved by the Ethics committee of the French Society of Ophthalmology.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.