Long-Term Visual Outcomes and the Timing of Surgical Repair of Fovea-Splitting Rhegmatogenous Retinal Detachments.

PURPOSE To evaluate the visual outcomes and the impact of timing of surgical repair of fovea-splitting rhegmatogenous retinal detachments (RRD). METHOD A retrospective, consecutive cohort from multiple surgeons at a single center. Fovea status (fovea-on, fovea-splitting, or fovea-off) was classified by preoperative optical coherence tomography. The primary outcome measure was visual acuity (VA) at last follow-up which was further correlated with the timing of surgical repair. RESULTS 195 eyes were included with 62 fovea-on, 65 fovea-splitting, and 68 fovea-off detachments. Mean preoperative logMAR VA for fovea-on, fovea-splitting, and fovea-off groups were 0.16±0.21, 0.70±0.56, and 1.67±0.87, respectively (p=<0.001). Mean postoperative logMAR VA for fovea-on, fovea-splitting, and fovea-off groups were 0.07±0.13, 0.10±0.15, and 0.20±0.22, respectively (p=<0.001). A statistically significant difference in mean postoperative logMAR VA was found between fovea-off and fovea-on groups (p=0.003) and between fovea-off and fovea-splitting groups (p=0.013), however not between fovea-on and fovea-splitting groups (p=0.827). VA improved when repair was performed earlier after presentation for fovea-on (R=0.378, p=0.002) and fovea-off groups (R=0.277, p=0.022), but not for the fovea-splitting group (R=0.089, p=0.481). CONCLUSION We described the favorable visual outcomes of surgery for fovea-splitting RRD and correlated these with the timing of surgical repair, which may help guide the management of this urgent, vision-threatening condition.