Prognostic Factors for Visual Postsurgical Outcome in Rhegmatogenous Retinal Detachment-A Systematic Review.

backgroundRhegmatogenous retinal detachment (RRD) is an ophthalmological emergency that can lead to vision loss if left untreated. Pars plana vitrectomy (PPV) is the preferred procedure for most complex RRD cases with a high success rate. However, certain parameters related to the patient, disease history, or ocular presentation may influence surgical outcomes.

methodsA systematic review of studies from 2010 to 2023 was conducted using PubMed/Medline (National Library of Medicine, Bethesda, MD, USA) and Scopus (Elsevier, Netherlands). The main objective of this review is to present the most significant data published in the scientific literature over the last 10 years, focusing on the latest implications of prognostic factors affecting the success of PPV in RRD. The search included terms such as "prognostic factors", "visual outcome", "functional outcome", and "rhegmatogenous retinal detachment". The database search returned 3489 studies. The included studies had to involve participants with RRD treated mainly by PPV, a minimum of 10 participants, and at least a 6-month follow-up period. Studies were excluded if they involved patients with previous PPV treatment or trauma. After reviewing their abstracts, titles, and applying the exclusion criteria, 19 articles were selected. Because it is an ample and interesting topic, many authors explored the connection between prognostic factors involved in the management of RRD and the final visual and functional outcomes. Methodological quality was assessed using PRISMA guidelines.

resultsvarious factors have been studied, ranging from classic ophthalmological parameters, such as refractive error, axial length, lens status, visual acuity, duration of symptoms, description of the RRD, and retinal tears, to more complex findings on optical coherence tomography.

conclusionsThe factors that significantly influenced postoperative prognosis in RRD included preoperative best-corrected visual acuity (BCVA), duration of symptoms, macular status (on/off), extent of retinal detachment, presence of macular hole, and proliferative vitreoretinopathy (PVR). Disruption of the ellipsoid zone (EZ), presence of epiretinal membrane (ERM), and lack of external limiting membrane (ELM) integrity were associated with poorer outcomes following RRD surgery.