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Functional and anatomical outcomes of fovea on, fovea off and fovea-splitting rhegmatogenous retinal detachment

  • Retinal Disorders
  • Published:
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Abstract

Purpose

To compare the anatomical and functional outcomes of fovea-on, fovea-off, and fovea-split rhegmatogenous retinal detachment (RRD).

Methods

Retrospective case series of consecutive patients diagnosed with RRD and treated with only pars plana vitrectomy (PPV). Preoperative and postoperative optical coherence tomography (OCT) and functional outcomes were obtained prior to and 6 months after surgery. RRD extending to the edge of the fovea on OCT was termed fovea-split RRD.

Results

A total of 152 eyes were included, out of which 89 eyes presented with a fovea-off, 36 with a fovea-on, and 27 with a fovea-split RRD. The mean visual acuity (VA) preoperatively was 1.32 ± 0.58 logMAR (20/400 equivalent on Snellen chart), 0.19 ± 0.20 (20/30), and 0.71 ± 0.56 (20/100) for the fovea-off, fovea-on, and fovea-split groups, respectively (p < 0.001). The mean VA at 6 months of follow-up significantly improved for the fovea-split and fovea-off groups to 0.54 ± 0.79 (20/70) (p < 0.001) and 0.45 ± 0.29 (20/50) (p = 0.01), respectively, and remained stable for the fovea-on group 0.24 ± 0.20 (20/30) (p = 0.25). Differences in alterations of the outer retinal layers (p < 0.001) and in the in-segment/outer-segment ratio (p < 0.001) were found between the groups.

Conclusion

Eyes with fovea-split RRD had both a preoperative and a final postoperative VA between those of fovea-on and fovea-off eyes and different anatomical changes on OCT. This new entity warrants different patient expectations for postoperative outcomes.

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Authors and Affiliations

  1. Division of Ophthalmology, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239, Tel Aviv, Israel

    Dana Barequet, Dana Zvi, Ram Cohen, Omer Trivizki, Shulamit Schwartz, Adiel Barak, Anat Loewenstein & Gilad Rabina

  2. Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Dana Barequet, Rachel Shemesh, Dana Zvi, Ram Cohen, Omer Trivizki, Shulamit Schwartz, Adiel Barak, Anat Loewenstein & Gilad Rabina

  3. Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel

    Rachel Shemesh

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  1. Dana Barequet
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  2. Rachel Shemesh
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  3. Dana Zvi
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Correspondence to Dana Barequet.

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This article does not contain any studies with human participants or animals performed by any of the authors. The study was approved by the institutional review board (IRB) of the Tel Aviv Medical Center, Tel Aviv, Israel, and complied with the tenets of the Declaration of Helsinki.

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Barequet, D., Shemesh, R., Zvi, D. et al. Functional and anatomical outcomes of fovea on, fovea off and fovea-splitting rhegmatogenous retinal detachment. Graefes Arch Clin Exp Ophthalmol 261, 3187–3192 (2023). https://doi.org/10.1007/s00417-023-06169-z

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  • DOI: https://doi.org/10.1007/s00417-023-06169-z

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