Association between retinal vessel density and postoperative time after primary repair of rhegmatogenous retinal detachment

Long-Term Follow-Up of Macular Perfusion Evaluated by Optical Coherence Tomography Angiography after Rhegmatogenous Retinal Detachment Surgery

BACKGROUND

The goal of this study was to investigate macular microvascular changes using optical coherence tomography angiography (OCTA) at one year after successful rhegmatogenous retinal detachment (RRD) surgery.

METHODS

We performed a cross-section study including RRD treated by pars plana vitrectomy (PPV) with or without scleral buckling and SF6 tamponade. After 12 months, DRI-Triton SS-OCTA was performed. Superficial and deep retinal capillary plexuses (SCP and DCP), choriocapillaris (CC) vessel density (VD), and foveal avascular zone (FAZ) morphology were analyzed. Results were compared with the unaffected contralateral eye.

RESULTS

Sixty eyes were included. We observed an increase in VD in the central area of both the SCP and DCP in macula-off eyes treated with PPV + SB and in the SCP of macula-off eyes treated with PPV. Macula-off eyes had a diminished VD for both plexuses in the superior quadrant and in the SCP inferior quadrant in those treated with PPV + SB. The CC flow was diminished in the temporal quadrant of macular-off eyes treated with PPV + SB. Healthy eyes presented higher diameter values than macula-off eyes treated with PPV + SB. FAZ horizontal and vertical diameters were smaller in patients with macula-off RRD vs. macula-on RRD and control groups.

CONCLUSION

Macular vascularity remains almost unchanged one year after successful RRD surgery, irrespective of the surgical technique or prior macular status.

Long-Term Macular Vascular Changes after Primary Rhegmatogenous Retinal Detachment Surgery Resolved with Different Tamponade or Different Surgical Techniques

Background: The aim of this study was to assess long-term macular vascular changes and their correlation with functional recovery in patients successfully treated for Macula-ON and Macula-OFF rhegmatogenous retinal detachment (RRD). Methods: This retrospective observational study included 82 eyes of 82 patients who received primary successful retinal detachment surgery, 33 Macula-ON and 49 Macula-OFF. Superficial and deep capillary plexuses (SCP and DCP) were evaluated by optical coherence tomography angiography (OCTA), and were correlated with visual acuity (VA), surgical technique and tamponade at 12 months after surgery. The fellow eyes were used as controls. Results: At 12-month follow-up, there was a significant decrease in the vessel density (VD) in the SCP in the operated eyes compared to control eyes (p < 0.05) in both the Macula-ON and Macula-OFF groups. Vessel length density (VLD) decrease in SCP was more extended in the Macula-OFF group. No difference in the DCP perfusion parameters was found, compared to controls. Subgroup analysis dependent on the type of surgery or tamponade showed no significant differences of VD and VLD. An inverse correlation was found between the SCP VD and the duration of silicone oil (SO) tamponade (p = 0.039). A significant correlation was observed between parafoveal SCP VD and final best corrected visual acuity (BCVA) (p = 0.028). The multivariate linear regression analysis showed that only the type of tamponade was significantly correlated with the final BCVA in the Macula-ON group (p = 0.004). Conclusions: Our study described long-term perfusion changes in RRD after surgery, with lower SCP VD and VLD in the operated eyes compared to the fellow ones, not influenced by type of surgery or tamponade. The choice of tamponade and SO removal timing may affect functional outcomes, especially in Macula-ON RRD. In conclusion, such functional and perfusion changes can be considered biomarkers that highlight the relevance of careful management of this sight-threatening disease.

Differences in Vascular Density between Detached and Nondetached Areas in Eyes with Rhegmatogenous Retinal Detachment

We examined the vessel density (VD) of the deep capillary plexus (DCP) and choriocapillaris plexus (CCP) by optical coherence tomography (OCT) angiography in eyes with rhegmatogenous retinal detachment, which had similar amounts of detached and nondetached areas in the macula region, and then determined the morphology by OCT until 6 months after surgery. A total of 13 eyes of 13 patients whose average age was 55.8 ± 12.3 years and were successfully treated were enrolled in this study. Throughout the postoperative period, the VD of the DCP in the detached area decreased significantly compared to that in the nondetached area. Conversely, there was no significant difference in the VD of the CCP between the detached and the nondetached areas. The ratio of VD of both the DCP and CCP in the detached area to the in the nondetached area did not show significant changes during the follow-up period of 6 months. The ratio of VD of the DCP in the detached area to that in the nondetached area correlated significantly with the ratio of the external limiting membrane−ellipsoid zone (r = 0.57, p < 0.001) and ellipsoid zone−retinal pigment epithelium (r = 0.39, p < 0.001) thickness in the detached area to that in the nondetached area. A well-preserved DCP blood flow could result in the restoration of the outer retina.