Anatomic and functional follow-up of foveal microstructures after macula-off retinal detachment surgery

National audiencePurpose To describe the course of functional and anatomical damage after successful repair of macula‐off rhegmatogenous retinal detachment (RRD). Methods This was a prospective multicenter study including patients with successful surgery for macula‐off RRD between October 2011 and April 2014. Patients with pre‐existing macular diseases or with surgery failures were excluded. Each patient underwent a complete ophthalmologic exam at baseline and at one, three and six months after the surgery (M1, M3, M6), with an assessment of the best‐corrected visual acuity (BCVA) at 4 m using the standard Early Treatment Diabetic Retinopathy Study chart, and with Spectral‐Domain Optical Coherence Tomography (SD‐OCT) macular imaging. Results One hundred and three eyes of 103 patients from ten French centers, with a 63‐years median age (IQR: [58; 69]), were included. The median BCVA increased significantly from 63 [46; 73] letters at M1 to 73 [62; 80]) at M6, p < 0.01). SD‐OCT morphologic lesions in the outer retina significantly improved between M1 and M6: irregular hyporeflectivity of the photoreceptor outer segments (76.7% vs 61.5%, p < 0.01) and disruption of the inner/outer segment junction line (51.5% vs 26.2%, p < 0.01). The rate of epiretinal membrane did not significantly increase between M1 and M6 (9.7% vs 20.4%, p < 0.67). Conclusions These preliminary results of the study “DécOllement de REtine: Fonction et Anatomie (DOREFA)” show a slow recovery of the external retinal layers after a successful RRD surgery. These observations seem to be parallel to the progressive recovery of the visual function after the intervention. A better knowledge of functional and anatomical kinetics after macula‐off RRD constitutes a preliminary step to the study of factors influencing the visual prognosis