A patient with a rhegmatogenous retinal detachment involving the macula for 5 days undergoes successful scleral buckling. Postoperatively, the retina is flat but visual acuity remains 6/60. Which finding on OCT would best explain the persistent poor vision?
- A Subretinal fluid at the fovea
- B Disruption of the ellipsoid zone (IS/OS junction) ✓
- C Epiretinal membrane formation
- D Cystoid macular edema
Correct answer: B. Disruption of the ellipsoid zone (IS/OS junction)
Explanation
After successful retinal reattachment surgery for macula-off RD, photoreceptor outer segment integrity is the primary determinant of visual recovery. Disruption of the ellipsoid zone (inner segment/outer segment junction) on SD-OCT reflects photoreceptor damage and correlates strongly with poor final visual acuity. Subretinal fluid that persists would keep the retina elevated; CME and ERM can develop but are treatable. The ellipsoid zone disruption represents irreversible photoreceptor loss from prolonged detachment.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.