Quantitative microvascular change analysis using a semi-automated algorithm in macula- on rhegmatogenous retinal detachment assessed by swept-source optical coherence tomography angiography

Abstract

Purpose: To objectively evaluate the longitudinal changes observed in the retinal capillaries in eyes with macula on rhegmatogenous-retinal-detachment (RRD) assessed with Optical Coherence Tomography Angiography (OCTA) and to assess the role of these microvascular measures as potential biomarkers of postoperative visual outcomes. Methods: Prospective, longitudinal study conducted on consecutive patients who underwent 25G pars-plana-vitrectomy for primary RRD. Vessel-area-density (VAD), vessel-skeletal-density (VSD), and vessel-diameter-index (VDI) were assessed in the superficial (SCP) and deep (DCP) capillary-plexuses. Results: Twenty-three eyes with macula-on RRD were included in the study. Mean preoperative VDI, VAD, and VSD of the RRD-eye were 18.6±1.1, 0.43±0.02, and 0.17±0.01 in the SCP, and 18.6±0.6, 0.38±0.03, and 0.15±0.01 in the DCP, respectively. At month-6, 8 (34.8%) eyes achieved a best-corrected-visual-acuity (BCVA) gain ≥0.1 LogMAR. A preoperative VDI>17.80, VSD>0.170, and VDI-change >-0.395 in the SCP; and VDI>18.11 and VDI change >-0.039 in the DCP were predictors of achieving a BCVA-gain ≥0.1 LogMAR. Conclusions: Preoperative VDI in SCP and DCP, VSD in SCP, and their changes from preoperative values were predictors of visual outcomes. Quantitative OCTA analysis of capillary density and morphology may represent a potential predictive tool for surgical outcomes in RRD. The results reported in this study suggest that OCTA is a useful ancillary test for clinical disease management.