DISTORTION RESOLUTION AFTER VITRECTOMY FOR MACULA-INVOLVING RETINAL DETACHMENT REPAIR: Post Hoc Analysis of the PostRD Trial.

Edward J Casswell, David Yorston, Edward Lee, David G Charteris
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Abstract

Purpose: To investigate changes in subjective and objective distortion in the first 6 months after macula-involving retinal detachment repair.

Methods: Post hoc analysis of the PostRD trial: a prospective, multicentered randomized controlled trial. Two hundred and sixty-two patients with macula-involving retinal detachments undergoing repair with vitrectomy and gas tamponade were asked to complete a distortion questionnaire and objective distortion assessment (D chart) 2 and 6 months postoperatively. Visual acuity, retinal displacement (measured with fundus autofluorescence imaging), and quality of life were also recorded.

Results: Two months postoperatively 75.5% of patients reported subjective distortion, and this fell to 61.1% at 6 months. Over that period, distortion persisted in 56.5% of patients, resolved in 19.2%, and developed in 5.6%. Approximately one in four had resolution of their distortion by 6 months. The median overall and weighted D chart distortion scores fell between 2 and 6 months but 29% of patients had a worsening of D chart distortion score. D chart distortion scores were more closely correlated with amplitude of postoperative retinal displacement and quality-of-life scores in comparison with subjective distortion.

Conclusion: Subjective distortion and objective distortion are common after macula-involving retinal detachment, but can improve over time. Objective measures of distortion were more closely correlated with quality of life and retinal displacement in comparison with subjective distortion.

玻璃体切除术后黄斑视网膜脱离修复的畸变分辨率:后strd试验的事后分析。
目的:观察累及黄斑的视网膜脱离修复后6个月内主客观畸变的变化。方法:Post - strd试验的事后分析:一项前瞻性、多中心随机对照试验。我们对262例接受玻璃体切除和气体填塞修复术的黄斑性视网膜脱离患者进行了术后2个月和6个月的畸变问卷调查和客观畸变评估(D图)。同时记录视力、视网膜位移(眼底自体荧光成像测量)和生活质量。结果:术后2个月主观扭曲率为75.5%,术后6个月主观扭曲率降至61.1%。在此期间,56.5%的患者持续扭曲,19.2%的患者消失,5.6%的患者恶化。大约四分之一的人在6个月的时间里消除了他们的扭曲。总体和加权D图扭曲评分中位数在2至6个月之间下降,但29%的患者D图扭曲评分恶化。与主观畸变相比,D图畸变评分与术后视网膜移位幅度和生活质量评分的相关性更密切。结论:主客观畸变是累及黄斑的视网膜脱离后常见的现象,但随着时间的推移可得到改善。与主观畸变相比,客观畸变测量与生活质量和视网膜移位更密切相关。
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