AMD Does Not Affect Visual Outcomes of Macula-Off Retinal Detachment Repair

With regards to functional vision, the prognosis for patients undergoing  macula-off rhegmatogenous retinal detachment (RRD) surgery who have concomitant age-related macular degeneration (AMD) is similar to that of patients without AMD, according to research published in BMC Ophthalmology.

Researchers conducted a retrospective chart review to compare visual outcomes in eyes with RRD and AMD with a group of eyes that underwent macula-off RRD repair that did not have concomitant AMD. The main outcome measure was postoperative best-corrected visual acuity (BCVA) following pars plana vitrectomy (PPV), scleral buckle (SB), or combined PPV+SB in eyes with AMD vs eyes without AMD. 

A total of 191 eyes, 29 eyes with AMD and 162 eyes without AMD, were included in the study. Patients with AMD compared with those without AMD had more advanced age (median age, 75.6 vs 63.2 years; P <.0001) and higher frequency of pseudophakia (79.3% vs 58%; P =.0379).

The investigators found eyes without AMD (compared with those with AMD) had significantly different postoperative visual acuity overall (P =.0048), with BCVA ≥20/40 in 5.6% vs 3.5%, BCVA <20/40 to >20/200 in 77.2% vs 55.2%, and BCVA <20/200 in 10.5% and 37.9%, respectively. They also found eyes without AMD had a higher frequency of count fingers, hand motion, light perception, or no light perception vision (6.8% vs 3.5%; P =.023). However, the AMD and non-AMD patients did not differ significantly with regard to the frequency of final reattachment (P =1.00), in surgical approach (PPV, PPV/buckle, or primary buckle) (P =.7903), in tamponade agent (P =.4295), or in the frequency of complications.

“[This] study suggests AMD patients can expect similar outcomes to non-AMD patients after RRD repair,” concluded the researchers. “It appears that the routine use of best surgical practice to manage RRD in AMD is well worth the effort for patients. Though clinicians should be careful not to overestimate visual outcomes, patients can be assured that surgical intervention does offer the hope of functional vision.”

Limitations of the study included the retrospective design, small number of patients with both AMD and macula-off RRD, lack of vision tests beyond cone-mediated acuity, inability to age-match due to the older age of AMD patients, and difference in lens status with more pseudophakia in the AMD group.