Long‐term follow up of macular perfusion evaluated by optical coherence tomography angiography after rhegmatogenous retinal detachment surgery

AbstractPurpose: To investigate macular microvascular changes using OCTA in patients one‐year after a successful RDD surgery.Methods: Cross‐sectional study including RRD treated using PPV ± SB and SF6 tamponade. Eyes were divided related to their macular status previous surgery and depending on the surgical technique used. All the subjects underwent complete ophthalmological examinations including a 3x3 OCTA protocol using DRI‐Triton swept source (SS)‐OCT with a minimum 12 months follow‐up after the surgery. Retinal capillary plexuses and CC vessel density (VD) were studied. FAZ area and diameters were measured. Results were compared with the unaffected contralateral eye.Results: Sixty eyes of 57 patients with RRD were included. Mean age was 59.14 ± 9.52 years. PPV was performed in 68.3% of the eyes, associated to SB in 31.6%. The macula was affected in 38.3% of the eyes and unaffected in 61.7%. RRD macula‐off had lower VA than the contralateral eyes. No differences were observed in VD between RRD macula‐on eyes regardless of the surgical technique performed. However, one year after surgery, we observed a significantly increased VD in the central area of macula‐off RRD eyes treated with PPV + SB in both retinal plexuses and in the SCP of RRD treated with PPV compared to the fellow eyes. All the macula‐off treated eyes had a diminished VD for both SCP and DCP in the superior quadrant and in PPV + SB we also found a diminution in the inferior quadrant for the SCP. In the inferior quadrant, we only found a diminution in the SCP flow in macula‐off treated with PPV + SB. We found changes at the CC level in the temporal quadrant of the macular‐off treated with PPV + SB. We did not observe differences in FAZ area between any groups. FAZ horizontal and vertical diameters were statistically smaller in patients with macula‐off RRD.Conclusion: Macular vascularity remains almost unchanged in patients one year after successful RRD surgery, despite the surgical technique (VPP vs VPP + SB). Vascular changes are not remarkable in neither macula‐on not macula‐off RDD. We found an increase in VD in the central area of the retinal capillary plexus in patients after macula‐off RDD associated to a diminution in VD of both superior and inferior quadrants of the retinal plexuses suggesting changes in vascularization after macula‐off RRD surgery.