Retinal Displacement Following Incisional Rhegmatogenous Retinal Detachment Repair

A study presented at the American Society of Retina Specialists 2021 Annual Meeting detailed the incidence of retinal displacement on fundus autofluorescence (FAF) following rhegmatogenous retinal detachment (RRD) repaired with pars plana vitrectomy (PPV), scleral buckle (SB), or PPV/SB.

“Using FAF imaging, recent studies have found rates of retinal displacement after RRD repair to be as high as 44%,” the researchers wrote. As such, Michael N. Cohen and colleagues sought to analyze the rate of retinal displacement to determine if the incidence was comparable to previously reported rates and to assess if there were differences in eyes undergoing PPV, SB, or combination PPV/SB.

In this single-center prospective study, Michael N. Cohen and colleagues analyzed 88 patients. Between April 2020 and December 2020, FAF images were performed in 94 eyes following RRD. Retinal displacement was identified by imprinted retinal vessels on FAF photographs.

The analysis found that 21% of eyes had a macula-on RRD, and almost 80% had a macula off RRD. Also, about 47% of eyes underwent PPV alone, nearly 10% underwent SB alone, and 43.6% underwent combined PPV/SB. Nine eyes (9.6%) had retinal vessel imprinting on FAF consistent with retinal displacement.

No displacement was found in the SB-only cohort, according to the investigators. There were no statistically significant differences in the proportion of eyes with displacement between the three surgical groups (P=0.88). All observed displacement involved the inferior vasculature. Mean (±SD) preoperative logMAR visual acuity was 1.46 (0.96) and mean postoperative logMAR visual acuity was 0.55 (0.37; P<0.001).

“Retinal displacement after PPV and PPV/SB occurred in approximately 10% of cases and was not detected after SB. In eyes with macula-off detachments, those with displacement had worse postoperative visual outcomes compared to those without detectable displacement,” the researchers concluded. “The cause for the difference in our findings of retinal displacement after PPV and previously published rates requires further study.”

Source: Cohen M, et al. Retinal Displacement Following Incisional Rhegmatogenous Retinal Detachment Repair. Published for ASRS 2021; October 8-12, 2021, San Antonio, TX.