<p>Retinal Microvasculature Changes After Repair of Macula-off Retinal Detachment Assessed with Optical Coherence Tomography Angiography</p>

Abstract

To characterize the microvascular retinal changes after repair of macula-off rhegmatogenous retinal detachment (RRD) using optical coherence tomography angiography (OCT-A). Patients and Methods: A retrospective review of patients who underwent repair of macula-off RRD. Fellow unaffected eyes were used as controls. Post-operative OCT-A allowed comparison of vessel density (VD) and foveal avascular zone (FAZ) area in the superficial and deep retinal capillary plexus (DCP) as well as VD in the choriocapillaris layer. Results: Seventeen eyes of 17 RRD patients were included in the final analysis. There was a reduction in VD of the deep retinal capillary plexus in affected eyes compared to fellow eyes (p = 0.046). RRD eyes with reduced VD in DCP compared with their fellow control eyes had worse visual acuity after repair compared to those without (p = 0.032). No significant microvasculature changes were detected in the FAZ area and VD in the superficial capillary plexus and choriocapillaris compared to fellow eyes. Conclusion: In macula-off RRD eyes, significant microvascular changes were detected in the DCP using OCT-A even after successful anatomical repair. Decreased VD in the DCP compared to the fellow healthy eyes was correlated with worse visual acuity.

Microvascular changes on optical coherence tomography angiography after rhegmatogenous retinal detachment vitrectomy with silicone tamponade

“…This has been previously reported in various ischemic retinal diseases, and it is related to poor visual outcomes [ 12 , 26 ]. McKay et al reported that significant microvascular changes were detected in the DCP after successful macula-off RD repair with SO or gas tamponade [ 13 ]. We also found enlarged FAZ in the eyes with SO tamponade when compared with that in controls; this was markedly observed in both the SCP and DCP (p = 0.043, p = 0.002, respectively).…”

“…Some investigators have reported microvascular changes in the superficial capillary plexus (SCP) and in the deep capillary plexus (DCP) in patients with RRD after vitrectomy using SO or gas tamponade [10][11][12]. In contrast, others have suggested that the macular microvasculature remains intact [13,14]. However, there is a lack of research on quantitative microvascular changes in the different retinal vascular layers in patients with RRD who underwent SO tamponade depending on macular involvement.…”

Assessment of Vascular Changes in Patients after Pars Plana Vitrectomy Surgery Due to Macula-Off Rhegmatogenous Retinal Detachment

“…The retinal vascular plexus of healthy subjects is formed by a superficial capillary plexus (SCP) located in the ganglion cell layer and nerve fiber layer and a deep capillary plexus (DCP) located in the inner nuclear layers [ 12 , 13 ]. OCT-A has been used in the diagnosis and monitoring of treatment effects in the case of macular degeneration, retinal vein obstruction, diabetic retinopathy, posterior uveitis and optic neuropathies [ 14 , 15 , 16 , 17 ]. McKay et al [ 18 ] used the OCT-A technique to compare the vessel density (VD) and FAZ in the eyes of a group of patients, in which there was one affected eye that had undergone macula-off RRD and the fellow eye for each patient.…”

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“…Retinal microvasculature of the two capillary plexuses (SCP and DCP) and choriocapillary network are evaluated in detail, while ICP is not always included in most studies due to projection artifact [9][10][11]. Notably, the currently available evidence concerning potential macular alterations as seen on OCT-A after RRD repair has stirred controversy as the results of the studies have not been unequivocally confirmed [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31].…”

“…Obviously, gas is a widely utilized tamponading agent and its use accounts for a large fraction of cases [32][33][34][35][36][37][38][39]. Indeed, most studies comprehensively examine OCT-A characteristics of RRD eyes after PPV with gas tamponade [13][14][15][16][17][18][19][20][21][22][23][29][30][31], while there is limited evidence of those treated by PPV with SO or by scleral buckle [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. The primary anatomical success rates for RRD repair by PPV have been found to range from 64% to 96%.…”