Visual outcomes and predictive factors after pars plana vitrectomy for macula-off rhegmatogenous retinal detachment: a retrospective cohort from Southern Thailand
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Rhegmatogenous retinal detachment (RRD) is a vision-threatening condition requiring surgery. Although pars plana vitrectomy (PPV) is the preferred treatment for macula-off RRD, outcomes and visual recovery factors vary across studies. This study aimed to evaluate the outcomes of PPV for acute macula-off RRD and identify factors associated with a favorable visual outcome in Thailand. METHODS: This retrospective cohort study, we reviewed the electronic medical records of patients with acute macula-off RRD treated with PPV at Songklanagarind Hospital between 2018 and 2021, with a minimum follow-up was 12 months. Data collected included demographics, duration of macular detachment (from onset of central visual loss to surgery), best-corrected visual acuity (BCVA), and intraoperative findings. Anatomical reattachment rates and BCVA improvement were analyzed at 1, 3, 6, and 12 months using percentages and mixed-effects random-intercept linear regression. Factors associated with favorable visual outcomes were assessed using univariate and multivariate logistic regression and receiver operating characteristic curve analysis. RESULTS: In total, 140 eyes from 139 patients were analyzed. Mean logarithm of the minimum angle of resolution BCVA improved significantly from 1.50 (95% confidence interval [CI]: 1.41-1.59) at baseline to 0.78 (95% CI: 0.69-0.87) (p < 0.001), with retinal reattachment achieved in 132 eyes (94.3%). A final BCVA of 20/50 or better (≤ 0.4 LogMAR) was observed in 39 eyes (27.86%). Independent predictors of this outcome were PPV performed within 7 days of symptom onset (area under the receiver operating characteristic curve [AUC], 0.763; OR, 3.40; 95% CI, 1.42-8.19; p = 0.006), age ≤ 60 years (OR, 2.82; 95% CI, 1.20-6.62; p = 0.018), and the use of gas tamponade (OR, 2.59; 95% CI, 1.09-6.14; p = 0.030). CONCLUSIONS: PPV is an effective surgical approach for managing acute macula-off RRD. Early surgical intervention within 7 days of symptom onset, younger patient age ([Formula: see text]60 years), and the use of gas tamponade may be associated with better visual outcomes. These findings may have clinical relevance by supporting risk stratification, optimizing surgical decision-making, and improving patient counseling regarding visual prognosis.
Source: BMC Ophthalmology
Institution: Prince of Songkla University
Language: English
Topic: Retinal and Macular Surgery
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,990
OpenAlex ID: W7161650452