Postoperative choroidal vascularity index after the management of macula-off rhegmatogenous retinal detachment

Miguel A Quiroz-Reyes; Erick A Quiroz-Gonzalez; Miguel A Quiroz-Gonzalez; Virgilio Lima-Gomez

doi:10.1186/s40942-023-00454-z

Postoperative choroidal vascularity index after the management of macula-off rhegmatogenous retinal detachment

Int J Retina Vitreous. 2023 Mar 29;9(1):19. doi: 10.1186/s40942-023-00454-z.

Authors

Miguel A Quiroz-Reyes^{1

2}, Erick A Quiroz-Gonzalez^{3

4}, Miguel A Quiroz-Gonzalez³, Virgilio Lima-Gomez⁵

Affiliations

¹ Oftalmologia Integral ABC, Retina Department, Medical and Surgical Assistance Institution (nonprofit Organization), Affiliated with the Postgraduate Studies Division, National Autonomous University of Mexico, Av. Paseo de las Palmas 735 Suite 303, Lomas de Chapultepec, Mexico City, 11000, Mexico. drquiroz@prodigy.net.mx.
² Retina Department, Oftalmologia Integral ABC, Medical and Surgical Assistance Institution (nonprofit Organization), National Autonomous University of Mexico, Mexico City, Mexico. drquiroz@prodigy.net.mx.
³ Oftalmologia Integral ABC, Retina Department, Medical and Surgical Assistance Institution (nonprofit Organization), Affiliated with the Postgraduate Studies Division, National Autonomous University of Mexico, Av. Paseo de las Palmas 735 Suite 303, Lomas de Chapultepec, Mexico City, 11000, Mexico.
⁴ Institute of Ophthalmology, Fundacion Conde de Valenciana, Medical and Surgical Assistance Institution (nonprofit Organization), Affiliated with the Postgraduate Studies Division, National Autonomous University of Mexico, Av. Paseo, Mexico City, Mexico.
⁵ Juarez Hospital, Public Assistance Institution (nonprofit Organization), Av. Politecnico Nacional 5160, Colonia Magdalena de las Salinas, Mexico City, 07760, Mexico.

Abstract

Background: Rhegmatogenous retinal detachment (RRD) is a vision-threatening condition that can be treated with various surgical approaches. The role of scleral buckling remains controversial because of its potential long-term deleterious effects on choroidal vascular perfusion and the limited knowledge of this entity.

Methods: A total of 135 eyes were retrospectively selected, including 115 with surgically resolved RRD and 20 healthy control eyes. Of the surgically treated eyes, 64 underwent vitrectomy alone, while 51 underwent scleral buckling combined with vitrectomy. Best-corrected visual acuity (BCVA) was evaluated along with the choroidal vascularity index (CVI) as a metric for the state of the choroidal vasculature. BCVA was compared before and after surgery, and the postoperative BCVA was analyzed with the CVI using correlation and multivariate regression analyses.

Results: The preoperative BCVA of the RRD eyes was significantly worse than that of the control eyes, and significantly improved after surgery. However, the long-term postsurgical BCVA was still inferior to that of the control eyes. No significant differences in visual function were found between the two surgical groups. The average CVI was 57.35% in the control eyes, 63.76% in the eyes that underwent vitrectomy, and 53.37% in buckled eyes. The differences in CVI were significant among the three groups. Among the surgical patients, negative Pearson's correlations were found between CVI and postoperative BCVA (expressed in logMAR). A multivariate linear regression model containing four parameters revealed that CVI was the only variable with a significant influence on postoperative BCVA, while the length of time with a detached macula did not have an effect.

Conclusions: RRD surgery drastically restored vision, but the effect of RRD lingered, as postsurgical visual acuity remained inferior to that of the control eyes. The CVI varied between the treatment groups, likely due to both disease pathology and the impact of the surgery. The correlation between CVI and BCVA indicates the important role that the choroidal vasculature plays in visual function.

Keywords: Buckling procedures; Choroidal vascularity index; Primary vitrectomy; Rhegmatogenous retinal detachment.

Publication types

Review