AIM: To observe the macula structure of the macula-off rhegmatogenous retinal detachment(RRD)with optical coherence tomography(OCT)5 years after successful scleral buckling(SB)surgery and to analyze the correlation between the duration of macular detachment(DMD)and postoperative visual acuity with OCT image.

METHODS: Forty-seven eyes of 47 patients with macula-off RRD were retrospectively studied and follow-up was carried out for a period of 5 years. The correlation among the postoperative best-corrected visual acuity(VA), the DMD and the microstructural findings with OCT at the fovea were evaluated.

RESULTS: The sub-acute RRD(DMD<7d)shows a greater foveal thickness(226SymbolqB@88μm)than the prolonged one(DMD>7 days)(209SymbolqB@76μm)with no statistical difference(P=0.791). Meanwhile, the sub-acute RRD had better mean final VA 0.53, compared with the prolonged one of 0.25, with significant difference(Student's t-test, P=0.008). Among 47 eyes, foveal anatomic abnormalities were detected in 5 eyes(10%); disruption of the junction between the photoreceptor inner and outer segments(IS/OS)in 4 eyes, and with a disrupted external limiting membrane(ELM)also(8.5%); and the mean VA of these 5 patients was 0.15 lower after 5 years.

CONCLUSION: Sub-acute macula-off RRD has a better impact on the final visual recovery than the prolonged one. Furthermore, the retinal thickness in the fovea was positively correlated to the postoperative VA. The disrupted inner segment/outer segment(IS/OS)junction could be restored in the patients without disrupted ELM signals at the initial examination. The duration of macula-off RRD within 7d had fewer disrupted inner segment/outer segment(IS/OS)junction with disrupted ELM signals than those for more than 7d. It is recommended to perform OCT in cases where VA was not improved as expected.