title: Structural recovery of the detached macula after retinal detachment repair as assessed by optical coherence tomography.
abstract: OBJECTIVE
  To investigate correlations between preoperative and postoperative foveal microstructures in patients with macula-off rhegmatogenous retinal detachment (RRD).
  
  
  METHODS
  We reviewed the records of 31 eyes from 31 patients with macula-off RRD who had undergone successful re-attachment surgery. We analyzed data obtained from complete ophthalmologic examinations and optical coherence tomography (OCT) before and 9 to 12 months after surgery. All postoperative OCT measurements were taken with spectral-domain OCT, but a subset of preoperative OCT measurements were taken with time-domain OCT.
  
  
  RESULTS
  The mean duration of macular detachment was 15.5 ± 15.2 days, and mean preoperative best-corrected visual acuity (BCVA, logarithm of the minimum angle of resolution) was 1.03 ± 0.68. Preoperative visual acuity was correlated with retinal detachment height (p < 0.001) and the existence of intraretinal separation (IRS) along with outer layer undulation (OLU) (p = 0.022), but not with macula-off duration. The final BCVA was significantly correlated with integrity of the junction between the photoreceptor inner and outer segments (IS/OS) combined with the continuity of external limiting membrane (ELM) (p = 0.025). The presence of IRS and OLU on a detached macula were highly correlated with the final postoperative integrity of the IS/OS junction and the ELM (p = 0.017).
  
  
  CONCLUSIONS
  Eyes preoperatively exhibiting IRS and OLU showed a higher incidence of disruption to the photoreceptor IS/OS junction and the ELM at final follow-up. Such a close correlation between preoperative and postoperative structural changes may explain why ultimate visual recovery in such eyes is poor.
authors.affiliation: Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Soo Geun
authors.initials: SG
authors.lastname: Joe
authors.forename: Yoon Jeon
authors.initials: YJ
authors.lastname: Kim
authors.forename: Ju Byung
authors.initials: JB
authors.lastname: Chae
authors.forename: Sung Jae
authors.initials: SJ
authors.lastname: Yang
authors.forename: Joo Yong
authors.initials: JY
authors.lastname: Lee
authors.forename: June-Gone
authors.initials: JG
authors.lastname: Kim
authors.forename: Young Hee
authors.initials: YH
authors.lastname: Yoon
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005584:Fovea Centralis / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008266:Macula Lutea / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012163:Retinal Detachment / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D055815:Young Adult
keywords: Intraretinal layer separation; Junction between the photoreceptor inner and outer segments; Optical coherence tomography; Outer retinal layer undulation; Rhegmatogenous retinal detachment