Postoperative Ocular Perfusional Findings in Successfully Reattached Severe Proliferative Vitreoretinopathy, An OCT-A Evaluation

Rhegmatogenous retinal detachment (RRD) is the separation of the neurosensory retina from the underlying retinal pigment epithelium (RPE) and is one of the leading causes of severe vision loss when it involves the macula or proliferative vitreoretinopathy (PVR) in different stages. Optical coherence tomography (OCT) and Optical coherence tomography - angiography (OCT-A) have opened a new scenario in the investigation of macular microstructural abnormalities in RRD.

Findings in the preoperative retinal detachment structural B-scans in OCT such as ellipsoid zone (EZ)/external limiting membrane (ELM) integrity, cavities along the inner nuclear layer (INL) or outer nuclear layer (ONL), retinal height of detachment at the fovea, presence of retinal folds and subfoveal choroidal thickness may predict the functional and structural outcomes.

Structural and en-face analysis with OCT-A in RRD with PVR has demonstrated an enlarged foveal avascular zone, and changes in the flow at the superficial, intermediate and deep capillary plexus during 6 months postoperative follow up. High resolution and deep enhancing imaging OCT-A technology will provide an important role regarding the choriocapillaris and choroid and their potential correlation with visual acuity recovery.

OCT and OCT-A will provide preoperative prognostic biomarkers and adequate vascular retinochoroidal layers may influence a postoperative outcome.

Keywords: Angiography, Outer nuclear layer (ONL), Rhegmatogenous retinal detachment (RRD), Retinal morphology, Retinal pigment epithelium (RPE).