Subfoveal fluid height (SFFH) can help clinicians predict visual outcomes following macula-off retinal detachment (RD) repair, according to study data published in the British Journal of Ophthalmology. The study shows that patients who experience an increase in SFFH are likely to have worse postoperative visual outcomes.

The prospective case series included 61 eyes from 61 patients (mean age 63.8 years, 44 men, 17 women) who underwent pars plana vitrectomy with gas tamponade (PPV) for macula-off RD with duration of symptomatic loss of central vision (LCV) of 1 week of less. All procedures occurred between October 2019 and September 2021. The preoperative SFFH was measured by 2 independent observers on 2 occasions using optical coherence tomography (OCT). At 3 months, postoperative best corrected visual acuity (BCVA) was measured.

All patients were pseudophakic following RD repair. The mean preoperative and postoperative BCVA at 3 months was 1.41±0.71 logMAR and 0.15±0.12 (range 0.00–0.70) logMAR, according to the study. 


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A total of 26 patients with SFFH of 1500 μm or lower were available for repeat OCT measurements. Researchers found that the change in SFFH varied based on the SFFH, with a logarithmic (base 2) association (r=0.50, P =.01). Patients were grouped according to their SFFH (group 1 [n=4] 1–100 μm, group 2 [n=7] 101–300 μm, group 3 [n=17] 301–700 μm, group 4 [n=17] 701–1500 μm, group 5 [n=16] 1501–3100 μm).  

At 3 months, BCVA significantly decreased with increasing SFFH from 0.04±0.03 in group 1 to 0.28±0.15 in group 5 (P <.001). However, BCVA at 3 months was not associated with age (P =.77), preoperative BCVA (P =.39), duration of LCV (P =.63) or use of perfluorocarbon liquids (P =.88).

Overall, 45 patients had SFFH of 1500 μm or lower and achieved 0.10±0.07 (range 0.00–0.30) logMAR, according to the report.  

Limitations of the study included a relatively small sample size and a relatively short-follow period (3 months).

“Visual acuity following PPV for macula- off RD is related to preoperative SFFH regardless of the duration of symptomatic LCV within the first week,” according to the researchers. “Since an increase in SFFH is associated with a worse visual outcome, and a clinician cannot know to what extent the preoperative SFFH will increase further and over what period, it would seem sensible to operate as soon as feasible, before there is further increase in SFFH.”

Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Reference

Baumann C, Almarzooqi A, Johannigmann-Malek N, Maier M, Kaye S. Importance of subfoveal fluid height on visual outcome in macula-off retinal detachments. Br J Ophthalmol. Published online July 19, 2022. doi:10.1136/bjo-2022-321604