title: Long-term visual acuity and the duration of macular detachment: findings from a prospective population-based study.
abstract: OBJECTIVE
  To report the long-term visual outcome of a multicentre prospectively recruited cohort of macula-off rhegmatogenous retinal detachments (RRD)   METHODS:  The Scottish retinal detachment study was a prospectively recruited study that recruited all incident cases of primary RRD in Scotland over a 2-year period (2007-2009). All patients with a macula-off RRD from four participating sites were invited for clinical examination at 6 weeks, 3 months, 6 months and 1 year after the initial surgery. Using a joinpoint model we estimated the effect of duration of macular detachment on final visual outcome.
  
  
  RESULTS
  In total, there were 291 patients with macula-off RRD without pre-existing retinal disease who had successful repair after one operation. 65.9% achieved a final visual acuity (VA) of 0.48 logMAR(6/18). Our model identified two time points (day 8 (95% CI 3 to 15 days) and (day 21 (95% CI 6 to 26 days)) after which there was a statistically significant worsening in final VA.
  
  
  CONCLUSIONS
  Our study suggests that the majority of patients with macula-off RRD successfully repaired with one operation will achieve a VA of 6/18 or better at final follow-up. After 8 days of macular detachment, the final visual outcome may be adversely affected and, thus, operative repair within this period is desirable. Duration of macular detachment of ≤8 days demonstrated a continuing improvement in VA for up to 1 year, a finding which was not found in macula detachments of longer duration.
authors.affiliation: Department of Ophthalmology and Public Health Sciences, University of Edinburgh, Teviot Place, Edinburgh EH3 9HA, UK. mitryd@gmail.com
authors.forename: Danny
authors.initials: D
authors.lastname: Mitry
authors.forename: Muhammad Amer
authors.initials: MA
authors.lastname: Awan
authors.forename: Shyamanga
authors.initials: S
authors.lastname: Borooah
authors.forename: Andreas
authors.initials: A
authors.lastname: Syrogiannis
authors.forename: Charles
authors.initials: C
authors.lastname: Lim-Fat
authors.forename: Harry
authors.initials: H
authors.lastname: Campbell
authors.forename: Alan F
authors.initials: AF
authors.lastname: Wright
authors.forename: Brian W
authors.initials: BW
authors.lastname: Fleck
authors.forename: David G
authors.initials: DG
authors.lastname: Charteris
authors.forename: David
authors.initials: D
authors.lastname: Yorston
authors.forename: Jaswinder
authors.initials: J
authors.lastname: Singh
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011379:Prognosis; D011446:Prospective Studies; D012163:Retinal Detachment / Q000453:epidemiology / Q000503:physiopathology*; D012606:Scotland / Q000453:epidemiology; D013997:Time Factors; D014792:Visual Acuity / Q000502:physiology*