| Objective To evaluate the correlation between macular mierostructure changes and visual outcome before and after scleral buckling for macular-off primary rhegmatogenous retinal detachment (RRD) by optical coherence tomography (OCT)Methods A total of 30 eyes in 30 patients with RRD were enrolled in this prospective study. All patients underwent scleral buckling and the retina was successfully reattached. All patients underwent thorough ophthalmologic examinations and optical coherence tomography before and at 2 days,2 weeks,1,3 and 6 months after surgery. The height of submacular fluids(SMF), the thickness of the macular foveal retinal were measured. The microstructure changes of external limiting membrane(ELM), junction line of photoreceptor inner segment/outer segment(IS/OS)were observed. The correlation between morphologic changes in the macular foveal and BCVA after surgery were analyzed.Results The mean preoperative BCVA was 0.21±0.16. The mean preoperative SMF height was (825.7±505.31) μm. The preoperative mean thickness of the macular foveal retinal in the RRD eyes were thicker than the healthy fellow eyes(t=-10.433,p=0.000<0.05). The detached retinas of 3D OCT images, including disrupted ELM, IS/OS line and photoreceptor outer segment reflective tape irregular or enlargement. SMF had been detected in 100.0%,90.0%,80.0%,66.7%,46.6% RRD eyes on 2 days,2weeks,1 months,3 months and 6 months after surgery, with heights of (198.83±153.69), (149.17±140.04), (86.87±80.71), (54.17±57.91), (24.53±38.40)μm respectively. Compared with preoperative, there were significant differences in the mean heights of SMF at 2 days,2weeks,1 months,3 months and 6 months after surgery (p<0.05)。The SMF detection rate on 6 months after surgery has nothing to do with age, course of the disease, the position and number of retinal tears. The thickness of the macular foveal retinal were (416.67+ 109.97), (343.27±105.99), (313.73±92.03), (259.77±59.96), (230.60+ 34.64), (214.83±29.22)μm. Compared with the healthy fellow eyes, there were significant differences in the mean thickness of the macular foveal retinal(t=-7.124、-6.438、-4.896、-3.693) at 2 days,2weeks,1months and 3 months after surgery(p<0.05), except for the thickness of the macular foveal retinal at 6 months after surgery(p=-1.903,p=0.062>0.05). The reattached retinas had 4 types of 3D OCT images, including:intact ELM,1S/OS line;intact ELM with disrupted IS/OS line; intact IS/OS line and disrupted ELM; disrupted ELM, IS/OS line. Best corrected visual acuity (BCVA) were 0.21±0.17,0.26±0.17,0.37±0.23,0.48±0.26,0.57± 0.28. Compared with preoperative, there were significant differences in the mean BCVA at 3 months and 6 months after surgery (p<0.05). The preoperative BCVA, SRF height, thickness of the macular foveal retinal were correlated with the BCVA at 6 months after surgery (r=0.438、-0.363、-0.450, p<0.05)Conclusions Macular-off RRD eyes had SRF, edema with the macular foveal retinal and disruption of ELM, IS/OS junction line before and after scleral buckling. The repairs of ELM, IS/OS junction line and the thickness of the macular foveal retinal can be seen in most of RRD patients at 6 months after surgery. The preoperative BCVA was positively related to the recovery of postoperative BCVA and SRF height, thickness of the macular foveal retinal were negatively correlated with the slow recovery of postoperative BCVA. |
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