Retinal detachment with macular involvement: in the struggle for maximal visual acuity. Part 1

The problem of improving visual acuity and functional outcomes in the treatment of macula-off rhegmatogenous retinal detachment remains relevant today. There is still no unified classification of this disease, which complicates the analysis and comparability of data from scientific studies. The first part of the review presents various classification options for macula-off rhegmatogenous retinal detachment, based on optical coherence tomography data of the macula. It provides data from experimental studies in this area, examines perioperative factors affecting the maximum final visual acuity, and analyzes the impact of the timing of surgical treatment of rhegmatogenous retinal detachment involving the macular area on the final maximal corrected visual acuity. Macula-off retinal detachment requires immediate surgical intervention due to better functional outcomes when the duration of macular detachment does not exceed 7 days. Despite achieving anatomical success after surgery for retinal detachment, in cases of pronounced microstructural morphological changes in the macular area, the final visual acuity may remain unsatisfactory. When predicting final visual acuity, a comprehensive assessment of the morpho-functional state of the macular retina is important.