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

Abstract

Purpose We aimed to evaluate microvascular changes on optical coherence tomography angiography (OCTA) in patients with rhegmatogenous retinal detachment (RRD) who underwent silicone oil (SO) tamponade and compare changes according to macular involvement. Methods This retrospective study included 48 patients with unilateral RRD who underwent vitrectomy and SO tamponade and were stable after SO removal. Control data were obtained from the fellow healthy eye. Ophthalmic examinations, including best corrective visual acuity (BCVA) and OCTA, were conducted. Differences in vascular density (VD) in different sections of the macula and differences in the foveal avascular zone (FAZ) were analyzed between the affected eyes and control eyes. Subgroup analyses according to macular involvement were performed. Results Baseline BCVA and duration of SO tamponade were associated with postoperative BCVA (p<0.001, p = 0.03, respectively). The average VD in the deep capillary plexus (DCP) and the VD of the nasal parafoveal area in both the superficial capillary plexus (SCP) and the DCP decreased relative to those in the control eyes (p = 0.026, p = 0.028, and p = 0.031, respectively). The FAZ area in the DCP and in the SCP also increased when compared with that in the controls (p = 0.043, p = 0.002, respectively). In addition, the macular-off RRD group had lower VD in the nasal parafoveal area of the DCP than the macular-on RRD group. Conclusion SO tamponade could cause microvascular changes, especially in the nasal parafoveal area. The macular-off RRD group were affected more than the macular-on RRD group.

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

“…Fang et al compared air and silicone oil endotamponade, and observed decrease of VD in both groups [22]. Lee and coauthors reported VD decrease after successful silicone oil removal [23].…”

Retinal and Corneal Changes Associated with Intraocular Silicone Oil Tamponade

“…Silicone oil tamponade may be associated with decreased macular vessels density, both in SO-filled eye and after ROSO ( Table 4 ). This may affect the superficial capillary plexus (SCP) alone [ 156 , 159 ] or the deep capillary plexus (DCP) alone [ 160 , 161 ], whereas the involvement of both plexuses has been less commonly reported [ 160 ]. On the one hand, it has been hypothesized that the SCP and the superficial retinal layers, being in contact with SO, could be more susceptible to potential SO-related mechanical/cytotoxic damage [ 159 ]; on the other hand, the DCP is considered more susceptible to ischemic damage due to its intraretinal location [ 162 ].…”

“…This may affect the superficial capillary plexus (SCP) alone [ 156 , 159 ] or the deep capillary plexus (DCP) alone [ 160 , 161 ], whereas the involvement of both plexuses has been less commonly reported [ 160 ]. On the one hand, it has been hypothesized that the SCP and the superficial retinal layers, being in contact with SO, could be more susceptible to potential SO-related mechanical/cytotoxic damage [ 159 ]; on the other hand, the DCP is considered more susceptible to ischemic damage due to its intraretinal location [ 162 ]. In addition, Liu et al [ 163 ] speculated that the superficial vascular changes might also be related to the elevation of IOP as they found a decreased parafoveal SCP VD only in eyes that had experienced raised IOP during the follow-up.…”

“…Indeed, the macular detachment itself may induce macular vascular changes in up to 71.1% of cases in the absence of SO endotamponade [ 164 ]. However, a lower parafoveal VD in the superficial capillary plexus (SCP) has been reported when comparing SO-filled eyes with air-filled after macula-off RD repair [ 159 ] and gas-filled eyes after macula-on RD repair [ 163 ]; this may support a specific role of SO in macular microvasculature effects. Moreover, the nasal sector and the FAZ of DCP may be more impaired in case of macular detachment [ 161 ].…”

“…Moreover, the nasal sector and the FAZ of DCP may be more impaired in case of macular detachment [ 161 ]. Finally, silicone oil-related microvascular changes may correlate with SO intraocular retention time [ 159 , 164 ]; whether these changes may recover after surgery remains controversial [ 159 , 160 , 165 , 166 ].…”