Fovea-On Retinal Detachment Damage Extends to Attached Retina 

Patients with fovea-on retinal detachment (RD) experience retinal damage that extends beyond the border of the detached retina, according to a prospective observational study published in Acta Ophthalmologica. The severity of retinal damage is associated with the distance to the RD, according to the report.

Researchers prospectively assessed 13 patients with fovea-on RD (mean age, 60 years; 9 men) and a healthy fellow eye between February 2020 and March 2021. All patients underwent either pars plana vitrectomy (n=11) or scleral buckling (n=2). 

Researchers obtained preoperative OCT scans of each patient’s RD border and macula. The RD border was highlighted on scanning laser ophthalmoscopy (SLO) imaging and microperimetry was performed to evaluate the retinal sensitivity at the macula, the RD border and the retina around the RD border. 

Patients underwent various follow-up examinations of OCT and microperimetry on the study eye. Microperimetry was performed only once in the healthy control eyes.

Preoperatively, the researchers found that the greatest loss in retinal sensitivity was 21 dB at 3° inside the RD which decreased approximately linearly, through the RD border, and reached a plateau of 2 dB at 4°.  

At 6 weeks and 3 months postoperatively, they found that the greatest retinal sensitivity loss remained at 3° inside the RD, but was 4 dB and sensitivity loss decreased linearly to a plateau of 0 dB at 5° outside the RD. At 6 months postoperatively, they found that the greatest sensitivity loss was 2 dB at 3° inside the RD, and decreased linearly to a plateau of 0 dB at 2° outside the RD.

“In conclusion, our study shows that retinal damage extends beyond the border of the detached retina in patients with fovea-on retinal detachment. Retinal sensitivity loss decreased drastically as the distance to the RD increased and reached a plateau starting at four degrees away from the RD,” according to the researchers. “Postoperative recovery of retinal sensitivity occurred for both attached and detached retina, but was slightly better for the attached retina which was at least two degrees away from the RD border.”

Study limitations include the small sample size, the displacement of the RD border during posturing and the interruption of posturing.