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November 2013

What Is the Optimal Timing for Rhegmatogenous Retinal Detachment Repair?

Author Affiliations
  • 1Retina Consultants of Houston, Houston, Texas
  • 2Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
  • 3Departments of Ophthalmology and Public Health Sciences, Penn State Hershey Eye Center, Penn State College of Medicine, Hershey, Pennsylvania
JAMA Ophthalmol. 2013;131(11):1399-1400. doi:10.1001/jamaophthalmol.2013.4505

Rhegmatogenous retinal detachment (RRD) is a common ocular disorder that occurs in approximately 1 of 170 eyes over a lifetime, often indicating urgent surgical intervention. Rhegmatogenous retinal detachments can be divided into fovea-sparing and fovea-involving detachments. In some cases, this distinction can be challenging and in these instances, central visual function, symptoms, and ocular coherence tomography (OCT) are helpful indicators of foveal status.

Preoperative visual acuity (VA) is the strongest prognostic indicator of postoperative visual outcome. When central visual function is preserved and subretinal fluid has not extended through the fovea, prognosis for visual recovery is often quite good, with approximately 80% of eyes ultimately achieving a VA of 20/40 or better. In comparison, when central vision is affected, indicating involvement of the foveal photoreceptors, prognosis is less optimistic and more variable with approximately 30% of patients ultimately achieving a VA of 20/40 or better.1