Evolution of macular microvasculature and retinal layers alterations in patients with macula off retinal detachment after vitrectomy

Abstract

Purpose: To examine the changes in retinal microvasculature in association with retinal layers’ condition in patients with rhegmatogenous retinal detachment (RRD) treated with pars plana vitrectomy (PPV). Methods: Participants in this study were 89 patients with macula off RRD, who were successfully treated with PPV and gas tamponade without internal limiting membrane peeling, in two centers. All participants underwent best corrected visual acuity (BCVA) measurement, slit-lamp examination, fundoscopy, spectral domain-optical coherence tomography (SD-OCT) and optical coherence tomography angiography (OCTA) at week 5, month 3 and month 6 postoperatively. The fellow untreated eyes were also examined and served as control data. Results: A statistically significant enlargement in foveal avascular zone (FAZ) in both superficial capillary plexus (SCP) and deep capillary plexus (DCP), accompanied with a statistically significant thinning of inner retinal layers, was noticed 5 weeks postoperatively. These changes, namely FAZ enlargement and thinning of inner retinal layers, in the operated eyes compared to the fellow eyes, remained unchanged till month 6 postoperatively. BCVA improved significantly from week 5 to months 3 and 6 postoperatively. The improvement in BCVA was associated with the gradual ellipsoid zone (EZ) recovery from the first (week 5) till the last examination (month 6). Conclusions: The FAZ enlargement in the operated eyes was accompanied with a statistically significant thinning in the inner retinal layers. Inter-correlation of BCVA and EZ integrity was noticed.

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

“…The fellow eye was used as a control. It is true that the SCP FAZ in the RRD group was greater than that in the control group, i.e., different than in our study, but the differences were not statistically significant ( p > 0.05) [ 44 ].…”

“…Furthermore, Christou et al [ 44 ] showed a lower VD in SCPs among 23 RRD patients who underwent PPV and applied gas endotamponade compared to the control. The fellow eye was used as a control.…”

Macular microcirculation changes after repair of rhegmatogenous retinal detachment assessed with optical coherence tomography angiography: A systematic review and meta-analysis

“…Twelve studies including 430 RRD eyes and 430 control eyes were selected in this study ( Agarwal et al, 2019 ; Woo et al, 2018 ; McKay et al, 2020 ; Ng et al, 2020 ; Wang et al, 2019 ; Hong et al, 2020 ; Bonfiglio et al, 2020 ; Barca et al, 2020 ; Christou et al, 2021 ; Liu et al, 2021 ; D'Aloisio et al, 2022 ; Chatziralli et al, 2022 ), as indicated in Table 1 . The search strategy for Pubmed is showed in Supplementary Table S1 .…”