Background: To evaluate, in patients undergoing macula-off rhegmatogenous retinal detachment surgery (RRD), the correlation between preoperative optical coherence tomography (OCT) morphological features and postoperative visual acuity. Methods: Retrospective interventional non-randomised clinical trial on 89 eyes of 89 patients undergoing pars plana vitrectomy for macula-off primary RRD at Policlinico Universitario Agostino Gemelli from 2020 to 2023. Preoperative 6×6 mm OCT B scans with Nidek Mirante (Nidek, Gamagori, Japan) were performed, collecting the following features: foveal involvement (fovea-on vs fovea-off), subretinal hyper-reflective points (HRPs), outer retinal corrugations (ORCs) and intraretinal cystic spaces (ICS) in the outer nuclear layer. The patients were followed in a 6-month follow-up to evaluate best-corrected visual acuity (BCVA) outcomes. Results: Preoperative mean BCVA was 0.15±0.22 and improved to 0.29±0.3 decimals at 6 months (p<0.001). The presence of subretinal HRPs showed a significant negative impact on BCVA improvement in the univariate regression analysis (r=-0.264, p=0.024), as well as the presence of foveal detachment (r=-0.355, p=0.012). The other OCT features did not show a significant correlation with BCVA improvement: ORCs (r=0.072, p=0.257) and ICS (r=-0.020, p=0.734). In the multivariate regression analysis, the negative impact of foveal detachment was confirmed (r=-0.199, p=0.05) while the statistical significance of subretinal HRPs was lost (r=-0.135, p=0.105). Conclusions: The negative impact of foveal involvement in a macula-off RRD was confirmed. Moreover, the presence of subretinal HRPs, as a possible indirect marker of inflammatory response extent, may act as a negative predictor for postoperative visual recover. Trial registration number: NCT05747144.

Savastano, M. C., Carla', M. M., Giannuzzi, F., Fossataro, C., Cestrone, V., Boselli, F., Biagini, I., Beccia, F., Raffaele, Q., Gravina, G., Rizzo, C., Savastano, A., Rizzo, S., OCT analysis of preoperative foveal microstructure in recent-onset macula-off rhegmatogenous retinal detachment: Visual acuity prognostic factors, <<BRITISH JOURNAL OF OPHTHALMOLOGY>>, 2024; 2024 (12): 1743-1748. [doi:10.1136/bjo-2024-325278] [https://hdl.handle.net/10807/300796]

OCT analysis of preoperative foveal microstructure in recent-onset macula-off rhegmatogenous retinal detachment: Visual acuity prognostic factors

Savastano, Maria Cristina;Carla', Matteo Mario;Giannuzzi, Federico;Fossataro, Claudia;Boselli, Francesco;Biagini, Ilaria;Beccia, Flavia;Gravina, Gianni;Savastano, Alfonso;Rizzo, Stanislao
2024

Abstract

Background: To evaluate, in patients undergoing macula-off rhegmatogenous retinal detachment surgery (RRD), the correlation between preoperative optical coherence tomography (OCT) morphological features and postoperative visual acuity. Methods: Retrospective interventional non-randomised clinical trial on 89 eyes of 89 patients undergoing pars plana vitrectomy for macula-off primary RRD at Policlinico Universitario Agostino Gemelli from 2020 to 2023. Preoperative 6×6 mm OCT B scans with Nidek Mirante (Nidek, Gamagori, Japan) were performed, collecting the following features: foveal involvement (fovea-on vs fovea-off), subretinal hyper-reflective points (HRPs), outer retinal corrugations (ORCs) and intraretinal cystic spaces (ICS) in the outer nuclear layer. The patients were followed in a 6-month follow-up to evaluate best-corrected visual acuity (BCVA) outcomes. Results: Preoperative mean BCVA was 0.15±0.22 and improved to 0.29±0.3 decimals at 6 months (p<0.001). The presence of subretinal HRPs showed a significant negative impact on BCVA improvement in the univariate regression analysis (r=-0.264, p=0.024), as well as the presence of foveal detachment (r=-0.355, p=0.012). The other OCT features did not show a significant correlation with BCVA improvement: ORCs (r=0.072, p=0.257) and ICS (r=-0.020, p=0.734). In the multivariate regression analysis, the negative impact of foveal detachment was confirmed (r=-0.199, p=0.05) while the statistical significance of subretinal HRPs was lost (r=-0.135, p=0.105). Conclusions: The negative impact of foveal involvement in a macula-off RRD was confirmed. Moreover, the presence of subretinal HRPs, as a possible indirect marker of inflammatory response extent, may act as a negative predictor for postoperative visual recover. Trial registration number: NCT05747144.
2024
Inglese
Savastano, M. C., Carla', M. M., Giannuzzi, F., Fossataro, C., Cestrone, V., Boselli, F., Biagini, I., Beccia, F., Raffaele, Q., Gravina, G., Rizzo, C., Savastano, A., Rizzo, S., OCT analysis of preoperative foveal microstructure in recent-onset macula-off rhegmatogenous retinal detachment: Visual acuity prognostic factors, <<BRITISH JOURNAL OF OPHTHALMOLOGY>>, 2024; 2024 (12): 1743-1748. [doi:10.1136/bjo-2024-325278] [https://hdl.handle.net/10807/300796]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/300796
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