Functional and anatomical outcomes of fovea on, fovea off and fovea-splitting rhegmatogenous retinal detachment

Dana Barequet*, Rachel Shemesh, Dana Zvi, Ram Cohen, Omer Trivizki, Shulamit Schwartz, Adiel Barak, Anat Loewenstein, Gilad Rabina

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Purpose: To compare the anatomical and functional outcomes of fovea-on, fovea-off, and fovea-split rhegmatogenous retinal detachment (RRD). Methods: Retrospective case series of consecutive patients diagnosed with RRD and treated with only pars plana vitrectomy (PPV). Preoperative and postoperative optical coherence tomography (OCT) and functional outcomes were obtained prior to and 6 months after surgery. RRD extending to the edge of the fovea on OCT was termed fovea-split RRD. Results: A total of 152 eyes were included, out of which 89 eyes presented with a fovea-off, 36 with a fovea-on, and 27 with a fovea-split RRD. The mean visual acuity (VA) preoperatively was 1.32 ± 0.58 logMAR (20/400 equivalent on Snellen chart), 0.19 ± 0.20 (20/30), and 0.71 ± 0.56 (20/100) for the fovea-off, fovea-on, and fovea-split groups, respectively (p < 0.001). The mean VA at 6 months of follow-up significantly improved for the fovea-split and fovea-off groups to 0.54 ± 0.79 (20/70) (p < 0.001) and 0.45 ± 0.29 (20/50) (p = 0.01), respectively, and remained stable for the fovea-on group 0.24 ± 0.20 (20/30) (p = 0.25). Differences in alterations of the outer retinal layers (p < 0.001) and in the in-segment/outer-segment ratio (p < 0.001) were found between the groups. Conclusion: Eyes with fovea-split RRD had both a preoperative and a final postoperative VA between those of fovea-on and fovea-off eyes and different anatomical changes on OCT. This new entity warrants different patient expectations for postoperative outcomes. [Figure not available: see fulltext.].

Original languageEnglish
Pages (from-to)3187-3192
Number of pages6
JournalGraefe's Archive for Clinical and Experimental Ophthalmology
Issue number11
StatePublished - Nov 2023


  • Fovea-split
  • Optical coherence tomography
  • Pars plana vitrectomy
  • Rhegmatogenous retinal detachment


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