Importance of subfoveal fluid height on visual outcome in macula-off retinal detachments

Aims To investigate the effect of subfoveal fluid height (SFFH) on visual outcome after macula-off retinal detachment (RD) repair. Methods Prospective interventional case series of consecutive patients undergoing pars plana vitrectomy with gas tamponade (PPV) for primary macula-off RD with duration of symptomatic loss of central vision (LCV) of <= 1 week. Preoperative SFFH was measured on two occasions an hour apart using optical coherence tomography (OCT) by two independent observers. Postoperative best corrected visual acuity (BCVA) was measured at 3 months. Results Sixty-one patients were included. All patients were pseudophakic after RD repair. The mean preoperative and postoperative BCVA (logarithm of the minimum angle of resolution) at 3 months was 1.41 (+/- 0.71) and 0.15 (+/- 0.12, range 0.00-0.70). Twenty-six patients with SFFH of <= 1500 mu m were available for repeat OCT measurements. The variation in SFFH was proportional to the SFFH and showed a logarithmic (base 2) association (r=0.50, p=0.01). Patients were therefore grouped according to their SFFH as group 1: 1-100 mu m, group 2: 101-300 mu m, group 3: 301-700 mu m, group 4: 701-1500 mu m and group 5: 1501-3100 mu m. BCVA at 3 months significantly reduced with increasing SFFH from 0.04 (+/- 0.03) in group 1 to 0.28 (+/- 0.15) in group 5 (p<0.001) but was not associated with age (p=0.77), preoperative BCVA (p=0.39), duration of LCV (p=0.63) or use of perfluorocarbon liquids (p=0.88). Forty-five patients had SFFH <= 1500 mu m and achieved 0.10 (+/- 0.07, range 0.00-0.30) logMAR. Conclusion Visual acuity following PPV for macula-off RD is related to preoperative SFFH regardless of the duration of symptomatic LCV within the first week.

Automated summary

This study aimed to investigate the impact of subfoveal fluid height (SFFH) on visual outcome after macula-off retinal detachment repair. The results showed that preoperative SFFH was related to postoperative visual acuity, but not associated with age, preoperative visual acuity, duration of symptoms, or use of perfluorocarbon liquids.