Background To evaluate, in patients undergoing macula-off rhegmatogenous retinal detachment surgery (RRD), the correlation between preoperative optical coherence tomography (OCT) morphological features and postoperative visual acuity. Methods Retrospective interventional non-randomised clinical trial on 89 eyes of 89 patients undergoing pars plana vitrectomy for macula-off primary RRD at Policlinico Universitario Agostino Gemelli from 2020 to 2023. Preoperative 6×6 mm OCT B scans with Nidek Mirante (Nidek, Gamagori, Japan) were performed, collecting the following features: foveal involvement (fovea-on vs fovea-off), subretinal hyper-reflective points (HRPs), outer retinal corrugations (ORCs) and intraretinal cystic spaces (ICS) in the outer nuclear layer. The patients were followed in a 6-month follow-up to evaluate best-corrected visual acuity (BCVA) outcomes. Results Preoperative mean BCVA was 0.15±0.22 and improved to 0.29±0.3 decimals at 6 months (p<0.001). The presence of subretinal HRPs showed a significant negative impact on BCVA improvement in the univariate regression analysis (r=−0.264, p=0.024), as well as the presence of foveal detachment (r=−0.355, p=0.012). The other OCT features did not show a significant correlation with BCVA improvement: ORCs (r=0.072, p=0.257) and ICS (r=−0.020, p=0.734). In the multivariate regression analysis, the negative impact of foveal detachment was confirmed (r=−0.199, p=0.05) while the statistical significance of subretinal HRPs was lost (r=−0.135, p=0.105). Conclusions The negative impact of foveal involvement in a macula-off RRD was confirmed. Moreover, the presence of subretinal HRPs, as a possible indirect marker of inflammatory response extent, may act as a negative predictor for postoperative visual recover. Trial registration number [NCT05747144][1]. Data are available on reasonable request. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT05747144&atom=%2Fbjophthalmol%2Fearly%2F2024%2F05%2F05%2Fbjo-2024-325278.atom

中文翻译：

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新发黄斑脱落孔源性视网膜脱离术前中心凹微结构的 OCT 分析：视力预后因素

背景旨在评估接受黄斑脱落性孔源性视网膜脱离手术（RRD）的患者术前光学相干断层扫描（OCT）形态特征与术后视力之间的相关性。方法 2020 年至 2023 年在 Policlinico Universitario Agostino Gemelli 进行的 89 例因黄斑脱落原发性 RRD 接受平坦部玻璃体切除术的患者的 89 只眼睛的回顾性介入非随机临床试验。术前使用 Nidek Mirante（Nidek、Gamagori、日本）进行了收集以下特征：中央凹受累（中央凹开启与中央凹关闭）、视网膜下高反射点（HRP）、视网膜外波纹（ORC）和外核层视网膜内囊性空间（ICS）。对患者进行为期 6 个月的随访，以评估最佳矫正视力 (BCVA) 结果。结果 术前平均 BCVA 为 0.15±0.22，6 个月时改善至 0.29±0.3 个小数点（p<0.001）。单变量回归分析显示，视网膜下 HRP 的存在对 BCVA 的改善具有显着的负面影响（r=-0.264，p=0.024），并且存在黄斑中心凹脱离（r=-0.355，p=0.012）。其他 OCT 特征与 BCVA 改善没有显示出显着相关性：ORC（r=0.072，p=0.257）和 ICS（r=−0.020，p=0.734）。在多变量回归分析中，证实了中心凹脱离的负面影响（r=-0.199，p=0.05），而视网膜下HRP的统计显着性丢失（r=-0.135，p=0.105）。结论 黄斑脱落 RRD 中黄斑中心凹受累的负面影响已得到证实。此外，视网膜下 HRP 的存在作为炎症反应程度的可能间接标志物，可能作为术后视力恢复的负面预测因子。试用注册号[NCT05747144][1]。可根据合理要求提供数据。 [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT05747144&atom=%2Fbjophamol%2Fearly%2F2024%2F05%2F05%2Fbjo-2024-325278.atom