Significance of outer retinal undulation on preoperative optical coherence tomography in rhegmatogenous retinal detachment

Rhegmatogenous retinal detachment (RRD) is a vision-threatening pathology. Optical coherence tomography (OCT) is useful for evaluating retinal damage and visual prognosis in patients with RRD. Outer retinal undulation (ORU) is often observed on preoperative OCT in RRD. Therefore, we evaluated the correlation between ORU seen on preoperative OCT and pre/post-operative factors in RRD. Patients with RRD (114 eyes) underwent reattachment surgery and >= 6 months of follow-up. According to the condition of the macula on preoperative OCT, cases were divided into macula-on RRD (65 eyes) or macula-off RRD (49 eyes). Patients were classified into acute (<10 days), subacute (10-30 days), and chronic (>30 days) symptom duration groups. Clinical findings, histories, and relationships with OCT findings, including ORU, were analyzed. Subacute symptom duration was significantly associated with ORU on preoperative OCT (p=0.001) and had a higher prevalence of ORU (73.7%) than did acute (OR=4.48) or chronic (OR=7.467) durations. Ellipsoid zone (EZ) disruption was significantly associated with poorer best-corrected visual acuity (BCVA) than normal EZ integrity at 6 months postoperatively (p=0.012). ORU on preoperative OCT suggests a 10-30 days morbidity duration in RRD. EZ integrity is useful for predicting postoperative BCVA in macula-off RRD.