Purpose. To evaluate morphologic changes of the macula, we observed eyes with rhegmatogenous retinal detachment (RRD) involving the macular region by optical coherence tomography (OCT). Subjects and Methods. We studied 26 eyes with RRD before and after surgery, assessing visual acuity, the height of retinal detachment at the fovea (HRD), and morphologic changes of the macular region. The interval between the onset and surgery was also determined. We examined the external limiting membrane (ELM) after surgery and the continuity of the inner segment-outer segment junction (IS/OS junction) of the photoreceptor layer. Results. Impairment of visual acuity was observed when HRD was over 1,000？μm, when there was outer nuclear layer edema before surgery, and when there was IS/OS junction disruption 3 months after surgery. However, 67% of eyes with a continuous ELM and IS/OS junction disruption 3 months after surgery eventually showed restoration of the continuity of IS/OS junction at 6 months. Conclusions. Impairment of visual acuity was observed in eyes with HRD ？μm, preoperative outer nuclear layer edema, and IS/OS junction disruption 3 months postoperatively. It is suggested that continuity of ELM might affect restoration of IS/OS junction after surgery for retinal detachment. 1. Introduction Surgery is required to reattach the retina in most eyes with rhegmatogenous retinal detachment (RRD). If the interval from onset to surgery is too long or if reattachment cannot be achieved, serious visual impairment can result, with blindness occurring in the worst cases. Various treatments for RRD are available depending on its severity and progression. Vitrectomy is sometimes required, especially for RRD involving the macular region (macula-off RRD). However, even when reattachment of the retina is achieved, postoperative visual impairment is generally unavoidable, and the visual outcome varies from case to case. In recent years, the structure of the retina has been clarified owing to advances in optical coherence tomography (OCT), and various reports have been published concerning factors that determine the visual outcome after retinopexy in patients with RRD [1–6]. In this study, determinants of the visual outcome were investigated retrospectively by spectral domain OCT in eyes with macula-off RRD that underwent surgical reattachment of the retinal. 2. Subjects and Methods The subjects were 26 patients (26 eyes) who underwent surgery after the diagnosis of macula-off RRD at the Department of Ophthalmology of Juntendo University, Shizuoka Hospital between April 2010
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