Foveal avascular zone analysis in eyes following retinal detachment repair: a comparison between eyes with retinal displacement vs without displacement

Abstract

Purpose : To compare morphological parameters of the foveal avascular zone (FAZ) in optical coherence tomography angiographic (OCTA) images in patients with vs without retinal displacement following rhegmatogenous retinal detachment (RRD) repair. Studies have reported that 40% of patients that undergo pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) repair have post-operative retinal displacement on Fundus Autofluorescence (FAF). However, no previous study compared FAZ features in eyes with vs without displacement prospectively. Our aim was to compare FAZ changes in eyes with vs without displacement following RRD.

Methods : We included all consecutive patients presenting with primary macula-off RRD where pneumatic retinopexy (PnR), PPV or scleral buckle were the treatment of choice. FAF images were evaluated by 2 masked graders for the presence of retinal vessel printing (RVP). The superficial FAZ in 3x3mm OCTA images were analyzed on ImageJ software by two graders, and the FAZ area, circularity and axial ratio were compared between eyes with vs without displacement post RRD repair. We also compared FAZ parameters in eyes following RRD repair vs the healthy fellow eye (control).

Results : FAZ of 126 eyes were evaluated, in a mean follow-up period of 91.05±28 days after RRD repair. FAZ area was similar between RRD eyes and controls (RRD 0.287±0.11 mm²; control 0.312±0.11 mm²; p=.221). There was a lower circularity score when comparing eyes with vs without retinal displacement found on FAF (eyes with displacement 0.59±0.10; eyes without displacement 0.64±0.10; p=.049). The circularity of the FAZ was significantly worse in eyes following RRD repair compared with controls (RRD 0.626±0.10; controls 0.667±0.11; p=.035) and the axial ratio was higher (less symmetric) in RRD eyes vs controls (RRD 1.26±0.17; controls 1.19±0.15; p=.034). There were no significant differences in FAZ parameters between patients undergoing pars plana vitrectomy, pneumatic retinopexy and scleral buckle in this cohort.

Conclusions : OCT-A may be useful to assess anatomical outcomes following RRD repair. This study demonstrates that retinal detachment has an impact on FAZ circularity. Our results show that retinal displacement might affect FAZ shape on OCT-A, and could be a useful biomarker to evaluate retinal displacement following RRD repair.

This is a 2020 ARVO Annual Meeting abstract.