Long-term outcome of macular shift after retinal detachment repair
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RETINAL DISORDERS
Long-term outcome of macular shift after retinal detachment repair Josef Guber 1,2
&
Megir Schawkat 1 & Hendrik P. N. Scholl 2,3,4 & Ivo Guber 5 & Christophe Valmaggia 1
Received: 17 August 2020 / Revised: 22 October 2020 / Accepted: 16 November 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background This study aimed to evaluate the long-term change of postoperative retinal shift after pars plana vitrectomy for macular off retinal detachment. Methods In this retrospective study, patients with retinal shift after pars plana vitrectomy for macula-off rhegmatogenous retinal detachment (RRD) were examined at 3 weeks and 12 months postoperatively. Fundus autofluorescence images were obtained to visualize retinal rotation. Best-corrected visual acuity was measured and metamorphopsia assessed using the Amsler grid. Results Nine patients with postoperative retinal shift were included in the study. Retinal shift decreased significantly in these patients, on average by 1.07° (range 0.52–1.62, p = 0.002) after 12 months. However, more patients complained of distorted vision after 12 months (odds ratio for change = 3.0, 95% CI: 0.24 to 157.49). The main reason was the new formation of an epiretinal membrane (odds ratio for change = infinity, 95% CI: 0.41 to infinity). There was no change in visual acuity observed (p = 0.16). Conclusion Postoperative retinal shift after RRD repair decreases over a 1-year span. While retinal shift is the main cause for metamorphopsia in the early postoperative period, formation of an ERM is the main reason for distorted vision long term.
Key messages Distorted vision after macula off retinal detachment is a common and known problem. One of the major causes is postoperative retinal shift. In this long-term study, patients with retinal shift were reviewed over a twelve months span. We noticed that retinal shift decreases spontaneously by time.
Keywords Metamorphopsia . Pars plana vitrectomy . Retinal detachment . Retinal shift
Introduction * Josef Guber [email protected] 1
Eye Clinic, Cantonal Hospital Sankt Gallen, Rorschacherstrasse 95, 9007 St. Gallen, Switzerland
2
Department of Ophthalmology, University of Basel, Basel, Switzerland
3
Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA
4
Institute of Molecular and Clinical Ophthalmology Basel (IOB), Basel, Switzerland
5
Department of Ophthalmology, University of Geneva, Geneva, Switzerland
Despite successful reattachment of the retina after pars plana vitrectomy, postoperative metamorphopsia, especially in macula off retinal detachments, is a common complaint postoperatively [1–10]. Younger patients seem to be at higher risk for distorted vision after surgery [5]. Recent studies have shown retinal shift as the main cause in up to 60% of cases in the early postoperative period whereas epiretinal membrane or ellipsoid zone defects are less important [1]. It is believed that subtle subretinal fluid remnant at the end of surgery and the force of gravity causes t
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