title: Characteristics of rhegmatogenous retinal detachment and their relationship to visual outcome.
abstract: OBJECTIVE
  To examine pre-operative characteristics of rhegmatogenous retinal detachment (RRD) and their relationship to visual acuity (VA) following surgery.
  
  
  METHODS
  Review of prospectively completed electronic database. Baseline characteristics, retinal drawings and outcomes were analysed.
  
  
  RESULTS
  In all, 847 eyes from 847 patients with a mean age of 62.2 years, 60% males, and 56% right eyes were studied. Mean follow-up was 9.6 months. Preoperative VA correlated with final VA (r(2)=0.21, P<0.0001). Median postoperative VA was 6/9 (Logmar 0.18, quartiles=0.0-0.48) and was significantly related to anatomical success: 70.15% achieved 0.18 or better with fully attached retina and primary success, whereas only 8.33% achieved this when the retina was not fully attached at final follow-up (failure) (P<0.0001). Univariate analysis found multiple variables associated with achieving 0.18 postoperative vision, however, multivariate analysis revealed only primary anatomical success with surgery; absence of proliferative vitreo-retinopathy (PVR), better-presenting VA and fewer quadrants of detachment were associated with a better visual outcome (r(2)=0.26, P<0.0001). Patients with a clinically attached fovea achieved better vision than patients with a clinically detached fovea, independent of the visual loss duration. With foveal detachment however, postoperative VA was better in patients with 1-3 days of visual loss compared with 4-6 days (P=0.013).
  
  
  CONCLUSIONS
  Failure of primary surgery, PVR, extensive RRD and poor-presenting VA are risk factors for poorer visual outcome following surgery for RRD. Fovea off RRD at presentation achieved poorer postoperative VA than fovea attached and visual outcome was poorer when there was a longer duration of visual symptoms.
authors.affiliation: Department of Ophthalmology, St Thomas' Hospital, London, UK.
authors.forename: T H
authors.initials: TH
authors.lastname: Williamson
authors.forename: M
authors.initials: M
authors.lastname: Shunmugam
authors.forename: I
authors.initials: I
authors.lastname: Rodrigues
authors.forename: M
authors.initials: M
authors.lastname: Dogramaci
authors.forename: E
authors.initials: E
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D011446:Prospective Studies; D012163:Retinal Detachment / Q000473:pathology / Q000503:physiopathology*; D012307:Risk Factors; D014792:Visual Acuity / Q000502:physiology*; D014822:Vitreous Body / Q000473:pathology