Macular displacement following rhegmatogenous retinal detachment repair

Aims To investigate the incidence of macula displacement and symptoms of distortion following rhegmatogenous retinal detachment (RRD) repair, quantify the displacement where seen and further characterise the nature of the displacement. Methods Consecutive patients undergoing primary RRD repair were assessed postoperatively with fundus autofluorescence and optical coherence tomography imaging, and the extent of macula displacement quantified using a novel means. Findings were examined for correlations with symptoms and pre-operative features. Results Macula displacement was evident postoperatively in 72% of 32 consecutive fovea-involving detachments treated with vitrectomy and gas. It was also evident in 5/17 foveal-sparing cases treated with vitrectomy and gas and in two of two patients with fovea-involving detachments treated with vitrectomy and oil. There was a significant correlation between the presence of macula displacement and symptoms of distortion in the early postoperative period (p=0.013). Symptomatic patients described bending of lines with or without objects appearing smaller or narrower in the operated eye. Quantifying the displacement demonstrated that the extent of displacement was associated with distance from the optic disc (p=0.005) and the extent of retinal detachment. Conclusions Displacement of the macula is common following RRD repair and heterogeneous in nature. Most affected patients are symptomatic in the early postoperative period.