Rotterdam Ophthalmic Institute, Rotterdam, the Netherlands.
The Rotterdam Eye Hospital, Vitreoretinal Surgery, Rotterdam, the Netherlands.
Invest Ophthalmol Vis Sci. 2020 Aug 3;61(10):34. doi: 10.1167/iovs.61.10.34.
To determine the impact of postoperative visual function on the vision-related quality of life (VRQoL) in patients after anatomically successful surgery for macula-off rhegmatogenous retinal detachment (RRD) and to propose a classification to grade the extent of macular detachment using preoperative optical coherence tomography (OCT) scans.
This prospective study evaluated 48 patients. At 12 months after surgery, visual function assessments were as follows: metamorphopsia (M-CHARTS), aniseikonia (New Aniseikonia Test), best corrected visual acuity (BCVA) (Early Treatment Diabetic Retinopathy Study [ETDRS]), low contrast BCVA (10% ETDRS), color vision (Hardy Rand Rittler), and stereopsis (Titmus Fly). VRQoL was assessed by the National Eye Institute Visual Functioning Questionnaire-25 (NEIVFQ-25). Associations between visual function parameters and NEIVFQ-25 scores were evaluated. Preoperative OCT-scans were classified into six stages according to the extent of macular detachment based on an ETDRS-grid: incomplete perifoveal detachment (1), incomplete parafoveal detachment (2), incomplete foveal detachment (3), complete foveal detachment (4), complete parafoveal detachment (5), and complete perifoveal detachment (6).
General vision and driving were the lowest scoring categories. General vision had the strongest correlation with low contrast BCVA (r = -0.41, P = 0.002), while driving had the strongest correlation with stereopsis (r = -0.39, P = 0.008). All macular detachments were graded stage 3 or beyond. Patients with stage 3 macular detachments had the highest visual function values compared to the other stages. The highest percentage of patients with metamorphopsia, aniseikonia and BCVA>0.1 logMAR was found in stages 5 and 6.
Macula-off RRD particularly affects general vision and driving. The extent of macular detachment is a potential predictor for visual function and can be graded using the proposed classification.
确定黄斑脱离性孔源性视网膜脱离（RRD）解剖复位手术后患者术后视力对视力相关生活质量（VRQoL）的影响，并提出一种使用术前光学相干断层扫描（OCT）扫描对黄斑脱离程度分级的分类方法。
本前瞻性研究评估了 48 名患者。术后 12 个月，进行以下视力功能评估：变形（M-CHARTS）、不等像（新不等像测试）、最佳矫正视力（BCVA）（早期糖尿病视网膜病变治疗研究[ETDRS]）、低对比度 BCVA（10% ETDRS）、色觉（Hardy Rand Rittler）和立体视（Titmus Fly）。VRQoL 通过国家眼科研究所视觉功能问卷-25 项（NEIVFQ-25）进行评估。评估了视力功能参数与 NEIVFQ-25 评分之间的关系。根据黄斑脱离的程度，根据 ETDRS 网格将术前 OCT 扫描分为六个阶段：不完全性中心凹旁脱离（1）、不完全性中心凹下脱离（2）、不完全性中心凹脱离（3）、完全性中心凹脱离（4）、完全性中心凹下脱离（5）和完全性中心凹旁脱离（6）。
一般视力和驾驶是得分最低的类别。一般视力与低对比度 BCVA 相关性最强（r = -0.41，P = 0.002），而驾驶与立体视相关性最强（r = -0.39，P = 0.008）。所有黄斑脱离均分级为 3 级或以上。与其他阶段相比，3 级黄斑脱离患者的视力功能值最高。在 5 级和 6 级中，发现有变形、不等像和 BCVA>0.1 logMAR 的患者比例最高。
黄斑脱离性 RRD 特别影响一般视力和驾驶。黄斑脱离的程度是视力功能的潜在预测因子，可以使用提出的分类进行分级。
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