Changes in Retinal Vessel and Retinal Layer Thickness after Vitrectomy in Macula-off Retinal Detachment Using Swept-source Optical Coherence Tomography Angiography

Abstract

Purpose : To compare post-vitrectomy retinal vessel density and retinal layer thickness between eyes with macula-off and macula-on rhegmatogenous retinal detachment (RRD) using swept-source optical coherence tomography (SS-OCT) and OCT angiography (OCTA) and to identify OCTA factors associated with visual outcome.

Methods : We retrospectively reviewed 50 eyes that underwent pars plana vitrectomy with primary RRD. Eyes with macula-off and macula-on RRD were compared with healthy fellow eyes. Both OCT and OCTA were performed at 6 months after surgery and macula-off RRD group was divided into two subgroups according to the presence of outer retinal defect on OCT. The correlation between postoperative best corrected visual acuity (BCVA) at 6 months and SS-OCT and OCTA measurements were analyzed.

Results : 15 eyes with macula-off RRD and 11 eyes with macula-on RRD were included. In the macula-off RRD group, the central retinal thickness was significantly decreased at postoperative 6 months compared to the fellow eyes (221.5 ± 26.4 µm and 270.0 ± 35.8 µm, p<0.001). In the outer retinal defect group, choroidal capillary plexus (CCP) vessel density (VD) was significantly decreased compared to the fellow eyes (207.3 ± 26.8 and 249.1 ± 40.5, p=0.018). Inner retinal thickness and superior and deep retinal capillary plexus VD did not show significant difference between detached eyes and fellow eyes in all groups. In the macula-off RRD group, the postoperative BCVA at 6 months was significantly correlated with the ratio of center CCP VD of the detached eyes to that of the fellow eyes (R2 =0.559, p=0.003).

Conclusions : The CCP VD may be related to anatomical restoration of the outer retinal layer in macula-off RD. CCP VD on OCTA may be one of OCTA marker to predict visual outcome after surgery of macula-off RD cases