Microvascular Changes After Scleral Buckling For Rhegmatogenous Retinal Detachment: An Optical Coherence Tomography Angiography Study

This retrospective study aimed at investigating macular microvascular alterations after successful scleral buckling (SB) for rhegmatogenous retinal detachment (RRD). Nine-teen eyes with macula-on RRD and 18 eyes with macula-off RRD were included. In all cases an encircling band was placed. Optical coherence tomography angiography (OCTA) was performed at baseline and postoperatively. Changes in foveal avascular zone (FAZ) area and vessel density (VD) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were the primary outcome. Correlations between OCTA findings and clinical variables were considered as secondary outcome. In both macula-on and macula-off groups, FAZ area was comparable with controls. In the macula-on group, VD in the whole SCP was lower compared with controls at both baseline (P < 0.001) and 6 months (P = 0.03), but showed a significant increase after surgery (P = 0.004). In the macula-off group, postoperative VD in both whole SCP and whole DCP was lower compared with controls (P < 0.001). In the macula-on group, there was an inverse correlation between axial length increase and SCP VD change (r=-0.508;P = 0.03). These findings demonstrated microvascular alterations after SB for RRD. However, VD impairment seems to mitigate after the surgery. A greater increase in postoperative axial length was associated with a poorer VD outcome.