Assessment of Microvascular Changes After Rhegmatogenous Retinal Detachment (RRD) Repair With Wide-Field Swept-Source Optical Coherence Tomography Angiography (WF SS-OCTA)

Abstract

Purpose : To evaluate microvascular changes in the macula and extra-macular region on WF SS-OCTA and assess their association with visual acuity (VA) following RRD repair.

Methods : We conducted a retrospective, cross-sectional, observational study of 241 patients imaged with WF SS-OCTA (PLEX® Elite 9000) between Dec. 2018 and June 2021. The Advanced Retinal Imaging Network (Zeiss Portal) was used to obtain vessel density (VD) and vessel skeletonized density (VSD) of the superficial capillary plexus (SCP), deep capillary plexus (DCP), and whole retina as well as foveal avascular zone (FAZ) parameters from 3×3 mm, 6×6 mm, and 12×12 mm fovea-centered scans. Mixed-effects multiple regression models adjusting for age, presence of diabetes mellitus or hypertension, lens status, extent and duration of detachment, and interval from surgery to imaging were used for statistical analysis.

Results : We included 97 eyes of 92 patients who underwent successful repair of macula-off (n=54) or macula-on (n=43) RRD, 67 unaffected fellow eyes, and 185 control eyes of 149 healthy patients. Median interval from surgery to imaging was 13 (3-78) months. Compared to controls, RRD eyes showed reduced SCP VSD (β=-0.18, p=0.02), VD (β=-0.02, p=0.01), and FAZ circularity (β=-0.06, p=0.004) in 3x3 mm scans and lower VSD/VD in the SCP (β=-0.87, p=0.04; β=-0.03, p=0.03), DCP (β=-1.17, p=0.03; β=-0.03, p=0.03), and whole retina (β=-0.90, p=0.05; β=-0.03, p=0.04) in 12x12 mm scans. RRD eyes also had lower SCP VSD (β=-0.55, p=0.03), VD (β=-0.01, p=0.01), and FAZ circularity (β=-0.06, p<0.001) in 3x3 mm scans than fellow eyes. Postoperative VA at the time of imaging was associated with SCP VD (β=-1.07, p=0.04) in 3x3 mm scans. Macula-off eyes had lower FAZ circularity (β=-0.05, p=0.02) than macula-on RRD eyes, while eyes treated with cryopneumatic retinopexy showed increased FAZ perimeter (β=0.71, p=0.009) and reduced circularity (β=-0.13, p=0.01) compared to vitrectomized eyes.

Conclusions : Vessel densities in the SCP and DCP were reduced on 3×3 mm and 12×12 mm scans of postoperative RRD eyes compared to controls and fellow eyes. SCP VD was significantly associated with postoperative VA.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

RRD eye (top) and healthy fellow eye (bottom): 12x12 mm (A1-2), 6x6 mm (B1-2) and 3x3 mm (C1-2) superficial angiogram, outlined FAZ (D1-2), perfusion (E1-2) and vessel traces (F1-2)