Role of Optical Coherence Tomography for Predicting Postoperative Visual Outcomes After Repair of Macula-Off Rhegmatogenous Retinal Detachment.

PURPOSE To identify any prognostic associations between preoperative optical coherence tomography (OCT) findings and postoperative visual outcomes in patients with macula-off rhegmatogenous retinal detachment (RRD). METHODS Retrospective, single-center study of patients diagnosed with macula-off RRD whom underwent surgical reattachment from 2012-2017. OCT images were analyzed by two retina surgeons. Outcome measures included "good" final vision (best corrected visual acuity of 20/40 or better), "poor" final vision (best corrected visual acuity of 20/200 or worse) and change in vision (worsened, improved, improved ≥ 15 letters) at most recent follow-up. P-values were calculated using t-tests, ANOVA, Wilcoxon rank sum or Kruskall-Wallis. RESULTS A total of 49 eyes were included. There was a significant difference in the mean preoperative central retinal thickness (CRT) between patients who had good final vision and patients who did not (96 um vs 161 um, p=0.048). In addition, a worse preoperative best corrected visual acuity and greater SRF height were associated with vision improvement (p<0.001). Those with persistent ellipsoid zone disruption postoperatively were less likely to have good final vision (OR = 0.217, 95% CI: 0.057-0.828). CONCLUSIONS A lower mean preoperative CRT is associated with good visual prognosis. Eyes with ellipsoid zone disruption postoperatively were less likely to have good final vision. Future studies should include a larger cohort of patients and more OCT variables to address the inconsistencies in the current literature.