CHANGES IN RETINAL MICROCIRCULATION AFTER RHEGMATOGENOUS MACULA-ON AMD MACULA-OFF RETINAL DETACHMENT ACCORDING TO OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY: A PROSPECTIVE STUDY

Abstract

Introduction. The aim of the study is to evaluate changes in the vascular density and microcirculation of various retinal layers following successful repair of rhegmatogenous retinal detachment without macular area detachment and with macular area detachment using optical coherence tomography angiography and their impact on postoperative clinical outcomes. Materials and Methods: A total of 33 eyes were included in this prospective consecutive observational study: 15 without macular area detachment affected by without macular area detachment and 18 by rhegmatogenous retinal detachment with macular area detachment. All patients were diagnosed as having primary rhegmatogenous retinal detachment (duration of retinal detachment less than 7 days since the onset) and underwent successful surgical treatment within 72 hours after diagnosis. Superficial, deep capillary plexus, and foveal avascular zone area variations were evaluated by optical coherence tomography angiography and correlated with visual acuity during a one-month follow-up. Results: In the without macular area detachment group, the preoperative vascular density of the whole superficial capillary plexus on affected eyes was lower than that of the fellow eyes (p < 0.05). The whole superficial capillary plexus vascular density and the parafoveal superficial capillary plexus vascular density increased during the follow-up period (p < 0.05); moreover, the higher the preoperative whole superficial capillary plexus and parafoveal superficial capillary plexus vascular density, the better the baseline visual acuity (p < 0.05) was. In the macular-on area detachment group, at the first months after surgery, the larger the foveal avascular zone, the lower the visual acuity was (p < 0.05). Conclusions. Consequently, optical coherence tomography angiography is a non-invasive investigation method that enables to assess retinal microcirculation in patients who have undergone surgical treatment for rhegmatogenous retinal detachment. The use of optical coherence tomography angiography offers a potential explanation for the suboptimal restoration of visual acuity despite anatomical restoration of the macula. In the macula-on group, the preoperative vascular density of the entire superficial capillary plexus affected the preoperative visual acuity and was lower than in healthy eyes, but recovered over time. Without macular area detachment superficial capillary plexus vascular density affected preoperative visual acuity, and it was lower than the fellow eye, but recovered over time. In the with macular area detachment group, a larger foveal avascular area was related to a worse visual acuity.