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

Evita Evangelia Christou; Panagiotis Stavrakas; Ilias Georgalas; Georgios Batsos; Eleni Christodoulou; Maria Stefaniotou

doi:10.1177/25158414221105222

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

Ther Adv Ophthalmol. 2022 Jun 18:14:25158414221105222. doi: 10.1177/25158414221105222. eCollection 2022 Jan-Dec.

Authors

Evita Evangelia Christou¹, Panagiotis Stavrakas², Ilias Georgalas³, Georgios Batsos⁴, Eleni Christodoulou⁴, Maria Stefaniotou⁴

Affiliations

¹ Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45100 Ioannina, Greece.
² Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Patras, Patras, Greece.
³ First Department of Ophthalmology, General Hospital of Athens G. Gennimatas, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
⁴ Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.

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.

Keywords: macula-off; macular capillary plexus; optical coherence tomography angiography; rhegmatogenous retinal detachment; silicone oil.