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Investigation of causative factors for unusual shape of macula in eyes with macula-off rhegmatogenous retinal detachment



To determine the factors significantly associated with anterior protrusion of the macula in eyes with a macula-off rhegmatogenous retinal detachment (RRD) and to determine the relationship between the intraretinal cystoid cavities (ICCs) and the anterior protrusion and function of the fovea.

Study design

Retrospective cross-sectional study.


Sixty-nine eyes of 69 patients with successfully reattached macula-off RRD were retrospectively analyzed. Six radial spectral-domain optical coherence tomographic (OCT) images were used to evaluate the effects of the ICCs on detached macula and to measure the angle of the retina at the macula as a parameter to evaluate the anterior protrusion of the detached retina. The findings were compared to other parameters.


The mean angle of the retina at the macula was 143.1 ± 15.9° with a range of 108 to 172°. Preoperatively, 51 eyes (74%) had ICCs in the inner nuclear layer and/or the outer plexiform layer and Henle fiber layer complex, but none was present after surgery. Multivariate regression analyses revealed that the angle of the retina was significantly associated with the presence of ICCs (β = -0.637, P<0.001) and the height of subretinal fluid (β = -0.256, P = 0.005). Eyes with ICCs had poorer preoperative vision (P<0.001), narrower angle of the retina (P<0.001), and thicker subretinal fluid (P<0.001) than eyes without cavities.


The anterior protrusion in eyes with macula-off RRD is associated with the presence of ICCs. The presence of ICCs can affect preoperative function and morphology but does not affect postoperative function and morphology.

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We thank Professor Emeritus Duco Hamasaki of the Bascom Palmer Eye Institute for the discussions and editing of the final version of the manuscript.

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Correspondence to Takeshi Iwase.

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Conflicts of interest

T. Iwase, Grant (Alcon, Bayer); R. Tomita, None; E. Ra, None; C. Iwase, None; H. Terasaki, Grant, Honorarium for Lecturing (Otsuka, Santen, Alcon, Novartis, Wakamoto), Honorarium for Lecturing (Kowa), Honorarium (ROHTO), Honorarium for Lecturing, Consultant fee (Bayer), Honorarium for Lecturing, Non-financial support (ZEISS), Grant (HOYA).

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Corresponding Author: Takeshi Iwase

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Iwase, T., Tomita, R., Ra, E. et al. Investigation of causative factors for unusual shape of macula in eyes with macula-off rhegmatogenous retinal detachment. Jpn J Ophthalmol 65, 363–371 (2021).

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  • Rhegmatogenous retinal detachment
  • Optical coherence tomography
  • Macula-off
  • Intraretinal cystoid cavity