The factors affecting visual prognosis in patients who underwent pars plana vitrectomy because of regmatogenous retinal detachment

In our study, we aimed to evaluate the foveal microstructural changes of the patients who underwent surgery for regmatogenous retinal detachment(RRD) using spectral domain optical coherens tomography(OCT), to evaluate the correlation of these changes with postoperative visual acuity and to assess other factors affecting visual prognosis. Forty one eyes of 41 patients who were performed pars plana vitrectomy(PPV) for RRD between December 2010- July 2013 were enrolled. Patients were divided into 2 groups. Group 1 consisted of 24 patients who had improved best corrected visual acuity(BCVA) after postoperative sixth month; group 2 consisted of 17 patients, of 14 patients who had stable BCVA and 3 patients who had worsening BCVA after postoperative sixth month. Complete ophtalmological examinations were performed preoperative and postoperatively and all datas were recorded. OCT examinations were done in 1.,3. and 6. month and once in every 6 months postoperatively. In our study, 29 men (% 70,7), 12 women(% 29,3) for a total 41 eyes of 41 patients were analyzed. The mean age was 61,24±9,49 years. The mean follow-up period 16,93±7,511 months. The duration between beginning of symptoms and diagnosis of retinal detachment was 12,04(median 6;range 2-90) days in group 1 and 9,06 (median 5;range 2-45) days in group 2. The duration between dignosis of retinal detachment and surgical treatment was 4,79(median 3,5;range 0-14) days in group 1 and 7,47(median 6; range 2-28) days in group 2. Twenty six (% 63,4) patients had macular detachment and 15(% 36,6) patients didn't have macular detachment. Fifteen(% 62,5) patients in group 1 and 11(% 64,7) patients in group 2 had macular detachment. In patients who didn't have macular detachment, both preoperative and postoperative BCVA was statistically significantly greater(p< 0,001). The mean preoperative BCVA was logMAR 1,37(median 1,4; min. 0,15, max. 2,10) in group 1 and logMAR 1,26(median 1,51; min.0, max. 2,10) in group 2. The mean postoperative BCVA was logMAR 0,17(median 0,18; min.0, max. 0,4) in group 1 and logMAR 0,58(ortanca 0,52; min. 0, maks 2,10) in group 2. When OCT results were compared, the number of patients who had continuous inner segment/outer segment (IS/OS) line were greater in group 1; in group 2 the number of patients who had disrupted IS/OS line and foveal epiretinal membrane (ERM) were greater. But no statistical analysis could be performed due to the limited numbers of patients. PPV technique is an effective surgical technique in the treatment of retinal detachment. There are many factors affecting visual prognosis in patients with RRD. Visual prognosis may be worse after successful surgical treatment even macula is anatomically reattached. It reveals that anatomically reattached macula doesn't mean it is functional. Spectral domain OCT helps us understanding foveal microstructural changes and may give us valuable datas about possible reasons of changes in visual acuity after anatomically successful surgical treatment of RRD. Keywords : Optical coherens tomography, retinal detachment