Review Article

Retinal Displacement: Providing New Insights for Retinal Detachment Surgery

Table 2

Outcomes of interest.

Author, yearFinal surgical outcomePresence of retinal displacement N (%)Amount and direction of retinal displacementVisual acuityPresence of visual symptomsOCT outcomesFinal follow-up time

Shiragami [3]All successful reattachment27/43 (62.8%)Downward = 43 eyesSignificant improvement in all patientsNo patients complained of cyclovertical diplopia or slantN/A6 months
1–5° extorsion = 16 eyes
1–4° vertical deviation = 13 eyes

Pandya [6]1 failed reattachment5/5 (100%)Downward = 5 eyesSignificant improvement in all patientsVertical diplopia reported in 3/5 patients and 1/5 patients at 3-month follow-upResidual subfoveal fluid = 1/5Mean follow-up: 5.8 months
Inferior redetachment = 1/5

Brosh [7]All successful reattachmentPPV = 55/124 (44.4%)Upward:Significant improvement in all patientsVertical:Interdigitation zone abnormalities on the 6 mm OCT:Median follow-up: 3 months
PR = 8/114 (7%)PPV = 3 eyesWith displacement:With displacement:
PR = 6 eyes25/30 (83.3%)55/57 eyes (96.5%)
Downward:Without displacement:Without displacement:
PPV = 52 eyes65/117 (55.6%)135/162 patients (83.3%) eyes
PR = 2 eyesHorizontal:
Mean displacementWith displacement:
PPV = 0.297 mm20/30 (66.7%)
PR = 0.137 mmWithout displacement:
62/117 (53%)

Schawkat [8]All successful reattachment17/50 (34%)Ranged between 1.0° and 7.5°Significant improvement in all patients10/17 of patients with retinal displacementN/A6 weeks

Dell’Omo [10]All successful reattachment40/125 (35.2%)Upward = 5 eyesSignificant improvement in all patientsNo patients complained of cyclovertical diplopia or slant.OCT sections of RVPs did not reveal characteristic features12 months
Downward = 39 eyes
18–58° extorsion = 28 eyes
18–38° intorsion = 3 eyes
18–48° vertical deviation = 13 eyes

Codenotti [11]All successful reattachment12/23 (52.2%)Downward = 10 eyesSignificant improvement in all patients2/23 complained of vertical diplopia and vision distortionN/A3 months
Upward = 2 eyes

Cobos [15]All successful reattachment12/20 (60%)Downward = 12 eyesSignificant improvement in all patientsN/AOCT analysis showed no differences in retinal displacement cases3 months

Casswell [13]All successful reattachment100/203 (49.26%)Face-down = 0.5° at 8 weeks, 0.3° at 6 monthsSignificant improvement in all patientsMore diplopia reported in face-down patients (1.5%) compared to support-the-break (7.6%)N/A6 months
Support-the-break = 0.8° at 8 weeks, 0.9° at 6 months

Dell’Omo [16]All successful reattachment7/20 (35%)N/ASignificant improvement in all patientsN/AN/A4 weeks

Guber [9]All successful reattachment17/50 (34%)Downward shiftSignificant improvement in all patients10/17 with retinal shift reported distorted visionN/A2 months
Shift between 1.0° and 7.5°

Lee [5]All successful reattachmentPPV + gas:Displacement is typically heterogeneousN/APPV + gas:PPV + gas:Median follow-up: 29 days
Mac-off = 22/32 (72%)Magnitude of displacement associated with extent of retinal detachment in degrees of involvement above () and below the fovea ()Mac-off = 22/32 (72%)Mac-off = 15/32 (47%) ORF (n = 6); SRF (n = 1); outer-retinal photoreceptor layer defects (n = 3); ERM (n = 1); full thickness macular fold (n = 1) or hole (n = 1)
Mac-on = 5/17 (29%)Mac-on = 2/17 (12%)§Mac-on = 4/17 (24%)
PPV + SO : Mac-off = 2/2 (100%)ORF (n = 2); CME (n = 1); ERM (n = 1)

Shiragami [12]All successful reattachment38/86 (44.2%)Downward shiftN/AGroup 1 = 1/44 patientsN/A3 months
1–7° extorsion
1–9° vertical deviation

Dell’Omo [4]All successful reattachment4/33 (12.1%)N/ASignificant improvement in all patients22 (67%) complained of postoperative metamorphopsiaORF = 14 (42.4%)Median follow-up: 24 days
IRF = 16 (48.8%)
IS/OS skip reflectivity abnormalities = 8 (24.2%)
Photoreceptor IS/OS band disruption at the fovea = 10 (30.3%)

Casswell [14]All successful reattachment61.4% of FC imagesN/AN/AN/AN/A8 weeks
52.8% of cSLO images

147 patients were evaluated for metamorphopsia; 40 eyes in the SF6 group and 4 eyes in the SO group. Occurrence of retinal displacement was higher in eyes with gas tamponade (10 of 14 eyes; 71.4%) compared with eyes with silicone oil (2 of 9 eyes; 22.2%) (). At 6 months, retinal displacement was detected in 42 of 100 (42%) in the face-down positioning group vs. 58 of 103 (56%) in the support-the-break positioning group (odds ratio, 1.77; 95% CI, 1.01–3.11; ). §Of those with retinal shift, symptoms were present in 83% (19/23). Of those with evidence of shift, symptoms were present in 86% (19/22). CME  =  cystoid macular edema; ERM  =  epiretinal membrane; N/A = not available; ORF = outer-retinal fold.