title: Restoration of foveal thickness and architecture after macula-off retinal detachment repair.
abstract: OBJECTIVE
  To investigate the foveal changes after repair of macula-off rhegmatogenous retinal detachment (RRD).
  
  
  METHODS
  Prospective comparative case series. Twenty-four eyes of 24 patients with macula-off/fovea-on detachment (n = 9) and fovea-off detachment (n = 15) were studied. Serial optical coherence tomography (OCT) images taken at the same location were recorded at months 1, 3, 6, and 12 after operation. Fellow eyes were used as controls.
  
  
  RESULTS
  No significant changes of the central foveal thickness (CFT) were recorded in the fovea-on group over the follow-up. From month 1 to month 12, CFT increased significantly in the fovea-off group (P < 0.00001). In this group, a significant increase of the Henle fiber and outer nuclear layer (HFL + ONL, P = 0.007), external limiting membrane (ELM)-ellipsoid zone (EZ; P = 0.03), and EZ-retinal pigment epithelium (RPE) thicknesses (P < 0.00001) was recorded. Significant restoration of the integrity of the ELM in the fovea-off group (P < 0.001) and of the EZ and cone interdigitation zone in the fovea-on group and the fovea-off group was observed (P = 0.02 and P < 0.001, and P = 0.002 and P < 0.001, respectively). Twelve months after operation the foveal bulge restored in 8 of 15 eyes of the fovea-off group. Multiple regression analysis showed that in the fovea-off group BCVA correlated with EZ-RPE thickness at months 1 and 12, whereas the improvement of BCVA during the 12 months follow-up correlated with the increase of ELM-RPE thickness.
  
  
  CONCLUSIONS
  Optical coherence tomography scans taken serially at the same location showed a progressive increase of HNL+ONL, ELM-EZ, and EZ-RPE thicknesses and restoration of the integrity of outer retinal bands after repair of fovea-off RRD. The use of software able to rescan at exactly the same area is crucial to correctly follow and interpret the reconstitution of the retinal bands and to correlate them to BCVA recovery.
authors.affiliation: Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy Eye Clinic "Villa Maria," Campobasso, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: dell'Omo
authors.affiliation: Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Viggiano
authors.affiliation: Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Giorgio
authors.affiliation: Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.
authors.forename: Mariaelena
authors.initials: M
authors.lastname: Filippelli
authors.affiliation: Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Di Iorio
authors.affiliation: Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.
authors.forename: Rocco
authors.initials: R
authors.lastname: Calo'
authors.affiliation: Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Cardone
authors.affiliation: Department of Ophthalmology, Second University of Naples, Naples, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Rinaldi
authors.affiliation: Eye Clinic "Villa Maria," Campobasso, Italy.
authors.forename: Ermanno
authors.initials: E
authors.lastname: dell'Omo
authors.affiliation: Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy Eye Clinic "Villa Maria," Campobasso, Italy.
authors.forename: Ciro
authors.initials: C
authors.lastname: Costagliola
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D005584:Fovea Centralis / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D020127:Recovery of Function; D012163:Retinal Detachment / Q000473:pathology* / Q000601:surgery; D013997:Time Factors; D041623:Tomography, Optical Coherence / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*; D014821:Vitrectomy
keywords: ellipsoid zone; foveal bulge; optical coherence tomography; retinal regeneration; rhegmatogenous retinal detachment