Macular microcirculation changes after macula-off rhegmatogenous retinal detachment repair with silicone oil tamponade evaluated by OCT-A: preliminary results

Abstract

Background: Rhegmatogenous retinal detachment (RRD) with macular involvement is a sight-threatening condition. Silicone oil (SO) is efficacious for retinal tamponade, especially in complex cases. Whether macular detachment per se or the potential tamponading agent may affect macular microcirculation after RRD repair is a matter of research. Objectives: To investigate macular microcirculation changes using optical coherence tomography angiography (OCT-A) after pars plana vitrectomy (PPV) with intravitreal SO for RRD repair in the early posttreatment period. Design: Prospective comparative cross-sectional study. Data sources and Methods: Fourteen eyes of 14 patients were included in the study. All eyes underwent a single successful PPV with SO tamponade for macula-off RRD. OCT-A was performed to analyze macular microcirculation and visual outcomes at 1 month postoperatively. The fellow unaffected eye was used as control. Results: Vessel density (VD) in the superficial capillary plexus (SCP) was significantly lower at each macular region (fovea, parafovea, and perifovea) of SO-treated eyes compared with the fellow eyes (all p = 0.001). Similarly, perfusion density (PD) in the SCP was significantly lower at each macular region than the fellow eyes (all p = 0.001). There was enlargement of foveal avascular zone (FAZ) area and decrease of circularity at RRD eyes compared with the fellow ones (all p = 0.001). Postoperative logMAR visual acuity (VA) was significantly lower in treated eyes than fellow eyes and correlated inversely with foveal, parafoveal, and perifoveal VD and PD SCP (all p < 0.001). Postoperative VA had no correlation with FAZ parameters. Conclusion: Enlargement of FAZ SCP and decrease in VD and PD SCP during the short-term follow-up were possibly attributable to ischemic changes in the macular area after RRD repair with SO tamponade. In this preliminary study, the flow density in macular capillary plexus may represent an indicator of visual outcomes.

Effect of silicone oil on retinal microcirculation after vitrectomy for rhegmatogenous retinal detachment evaluated by OCT angiography: a literature review

“…We identified 19 studies focusing on this topic. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] All included papers have considered the use of OCT-A for evaluating retinal microvasculature at the macula and the optic nerve and for identifying potential alterations in RRD eyes following vitrectomy with SO tamponade. This article is based on previously published studies and does not include any studies performed by the authors.…”

“…Finally, macular microcirculation changes after RRD with SO tamponade was analyzed by our team 26 in a prospective study with 14 patients. OCT-angiograms were captured in 6 × 6 mm 2 scans.…”

“… 7 – 10 Varying regions of the posterior segment vasculature of the eye, including the macula and the optic nerve have demonstrated alterations in RRD eyes undergoing vitrectomy with SO tamponade. 11 – 32 These emerging findings provide abundant evidence for the potential impact of SO on retinal microcirculation.…”

“…A literature search revealed numerous studies that focus on OCT-A characteristics of the retinal capillary network in RRD eyes after vitrectomy with intravitreal SO in an attempt to indicate the potential of a SO-related deleterious effect on retinal tissue. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] To our best knowledge, this is the first review article that presents selected pertinent evidence of OCT-A characteristics after successful RRD surgery with intravitreal SO, perceives possible explanations for the microcirculation status, and proposes the need for further future research.…”

Electroretinogram changes before and after silicone oil removal in eyes with macula-off rhegmatogenous retinal detachment

“…Longstanding intravitreal SO may lead to visual impairment due to anterior segment complications, such as secondary glaucoma, keratopathy, and cataract formation. It may adversely affect retinal function [5][6][7][8].…”