Predictive Factors for Macular Sensitivity and Fixation Stability After Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment Repair with Primary Pars Plana Vitrectomy: A Microperimetry Study

Abdullah H Al-Mulla,1 Abdulrahman I Al-Souih,1 Priscilla W Gikandi,1 Abdullah S Al-Kharashi,1 Ahmed M Abu El-Asrar1,2 1Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 2Arab National Bank Research Chair in Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Ahmed M Abu El-Asrar, Department of Ophthalmology, College of Medicine, King Abdulaziz University Hospital, King Saud University, King Abdulaziz Road, PO Box 245, Riyadh, 11411, Saudi Arabia, Tel +0096611-4786100ext.3370, Email [email protected]: To identify predictive factors for macular sensitivity and fixation stability following rhegmatogenous retinal detachment (RRD) repair using MP-1 microperimeter.Methods: Retrospective study of 66 eyes from 66 patients who underwent successful primary pars plana vitrectomy and had postoperative microperimetry assessment.Results: Median postoperative macular sensitivity was 12.9 decibels and median fixation stability was 81.5%. Median time between RRD repair and microperimetry testing was 10.0 months. Initial visual acuity ≥ 20/200 was associated with higher postoperative macular sensitivity (p=0.021) and fixation stability (p=0.004). Attached macula at presentation was associated with better macular sensitivity (p=0.041) and fixation stability (p=0.034). Gas tamponade resulted in superior outcomes compared to silicone oil for both macular sensitivity (p=0.004) and fixation stability (p< 0.001). Multivariate regression analysis identified gas tamponade as the most significant predictor for better macular sensitivity (odds ratio = 5.53; 95% confidence interval [2.11– 8.94]; p = 0.002). Significant negative correlations were observed between preoperative logarithm of the minimum angle of resolution (LogMAR) visual acuity and postoperative macular sensitivity (r=− 0.253; p=0.043) and fixation stability (r=− 0.408; p=0.001). Final LogMAR visual acuity was negatively correlated with macular sensitivity (r=− 0.581; p< 0.001) and fixation stability (r=− 0.421; p< 0.001).Conclusion: Better initial visual acuity, attached macula at presentation, and gas tamponade are significant predictors for better postoperative macular function after RRD repair.Keywords: rhegmatogenous retinal detachment, outcome, macular sensitivity, fixation stability