OCTA Analysis In Patients With Persistent Subretinal Fluid After Scleral Bucklimg Surgery For Retinal Detachment

Objective:To evaluate the correlation between morphologic changes in the macular region and visual function after scleral buckling surgery of rhegmatogenous retinal detachment in patients with persistent subretinal fluid by using the Optical Coherence Tomography Angiography.Methods:40 eyes of 40 people who were diagnosed with RRD in our hospital?Baoding First Central Hospital?were invloved in this study.All eyes received scleral buckling surgery and the retina was successfully reattached,but there were persistent subretinal fluid in OCT examination.A thorough ophthalmologic examination including best correct visual acuity?BCVA?, slit-lamp biomicroscopy,binocular indirect ophthalmology and Optical Coherence Tomography Angiography were performed preoperatively and at day 3,months l,3,6 postoperatively.Experimental group includes the eyes underwent the scleral buckling surgery.Healthy eyes consistent the control group.The height of the retinal neuroepithelial layer,subretinal fluid,choroid and superficial retinal capillary plexus vascular density,superficial retinal capillary plexus perfusion density,Choriocapillary layer image were acquired using OCTA.The morphologic changes in the macular foveal and visual function were also evaluated.Results:1.Best Corrected Visual Acuity?BCVA?:As time goes by,the BCVA was increased slowly,preoperative BCVA:0.20±0.18,BCVA at day 3,months l,3,6postoperatively:0.23±0.17,0.29±0.17,0.34±0.19,0.42±0.21.Postoperative BCVA at month 6 was correlated with preoperative BCVA?r=0.853,P<0.05?.2.Subretinal Fluid:The preoperative height of subretinal fluid was861.75±520.72?m,and distinctly decreased to 263.95±128.12?m at day 3.As time goes by,SRF was absorbed slowly.The height of SRF was correlated with postoperative visual acuities?r=-0.541,-0.702,-0.714,-0.649,P<0.05?.3.Retinal Neuroepithelial Layer:The height of RNL was significantly decreased at day 3 and increased over time.There was no statistically difference between experimental group and control group in postoperative retinal neuroepithelial layer?t=1.819,1.804,0.394,-0.986,P>0.05?.And there was no correlation between the height of SRF and RNL in preoperatively and postoperatively?r=-0.035,-0.244,0.113,0.245,-0.197,P>0.05?.There was no correlation between the height of SRF and the visual acuities in postoperatively?r=0.006,0.058,0.011,-0.195,-0.194,P>0.05?.4.The Height of Choroid:There was no correlation between the height of SRF and Choroid in preoperatively and postoperatively?r=0.091,-0.105,0.006,0.110,0.280,P>0.05?.The height of Choroid was correlated with the BCVA at month 6?r=-0.335,P=0.035?.5.Superficial Retinal Capillary Plexus Vascular Density and Perfusion Density:The postoperative superficial retinal capillary plexus vascular density and perfusion density were decreased as time goes by.There was no correlation between visual acuities with both SCP vascular density and perfusion density?r₁=0.169,0.201,0.204,0.065;r₂=0.078,0.237,0.066,0.103;P>0.05?.The SCP perfusion density was correlated with SRF negatively at months l,3,6?r=-0.366,-0.310,-0.399,P<0.05?.6.Choriocapillary Layer Perfusion Density:Compared with the healthy eye,the CCL perfusion density was decreased significantly at months 1,3,6?t=3.598,P=0.001;t=3.580,P=0.001;t=5.337,P=0.000?.There was no correla-tion between CCL perfusion with both BCVA?r=-0.051,-0.041,0.107,0.076,P>0.05?and the height of SRF?r=-0.072,-0.100,0.087,0.156,P>0.05?in post-operatively.Cinclusions:1.Preoperative visual acuity,persistent subretinal fluid and the height of choroid at month 6 are correlated with the recovery of visual function after surgery.2.SCP perfusion density has an effect on the absorption of subretinal fluid.3.Superficial retinal capillary plexus vascular density,superficial retinal capillary plexus perfusion density and the choriocapillary layer perfusion density have changed after surgery,but there are no correlation between visual function and these factors.