| Objective:For patients with rhegmatogenous retinal detachment(RRD)who underwent vitrectomy intraocular silicone oil tamponade surgery,clinically,after long-term silicone oil tamponade,we observed that the patient's fundus retinal vessels became thinner and the optic papilla became paler.These important signs often directly reflect physiological changes of the retina,optic disc and visual prognosis.Therefore,we used optical coherence tomography angiography(OCTA)to detect and analyze the effects of silicone oil tamponade on blood flow density and nerve fiber layer thickness in the optic disc area.Methods:A total of 30 patients and 30 eyes were selected as the observation group from December 2018 to December 2019.Patients who were diagnosed with RRD in one eye underwent vitrectomy + retinal repair + silicone oil tamponade surgery by the same surgeon.According to the range of retinal detachment,it was divided into>2 quadrants groups and ?2 quadrants groups.A prospective follow-up study was performed.All patients had retinal detachment completely reset after surgery and were followed up for 3 months.At the same time,healthy eye of each patient,a total of 30 eyes were used as the control group.Recording the basic information of the patients,and performing detailed eye examinations on the healthy and observed eyes of the selected patients preoperatively,1 month and 3 months after operation,including the best corrected visual acuity(BCVA),intraocular pressure(IOP),chamber angles examination,anterior segment examination of slit lamp,fundus examination of mydriatic slit lamp combined with 90 D front mirror,biomicroscopy with three mirror contact lens,fundus photochromy,color doppler ultrasound examination,optic disc OCTA examination.The OCTA examination measures the blood vessel density of the radial peripapillary capillary(RPC),including: the whole image of optic disc blood flow density,peripapillary blood flow density,inside disc blood flow density,superior,inferior,nasal,temporal blood flow density in each quadrant,and the average RNFL thickness around the optic disc.Statistical analysis was performed on the detected data.Results:1.In terms of BCVA: 1 month after operation,the BCVA of 19 patients was improved compared with preoperation,an increase rate of 63.33%;3 months after operation,the BCVA of 26 patients was improved compared with preoperation,an increase rate of 86.67%;3 months after operation,the BCVA of 19 patients was improved compared with 1 month after operation,an increase rate of 63.33%.2.In terms of IOP: 1 month after operation,all people were within the normal range;3 months after operation,27/30 were within the normal range,3/30 were slightly higher than the normal range(between 22-26mmHg)and continued for 3-5 days,IOP can be reduced to normal and stability after symptomatic treatment of 1 or 2 kinds of eye drops for reducing intraocular pressure.3.>2 quadrants groups in terms of blood flow density and RNFL thickness:(1)Preoperatively,1 month and 3 months after operation,blood flow densities in the whole image,inside disc,peripapillary and in the superior and nasal quadrant were compared with those in the control group,blood flow density decreased(P <0.05).(2)Compared with the control group,the blood flow density in the temporal quadrant was lower 3 months after operation(P<0.05),and preoperation,1 month after operation,the blood flow density compared with the control group respectively,the difference was not statistically significant(P > 0.05).(3)In the inferior quadrant,compared with the control group,the blood flow density decreased 1 month after operation(P<0.05);but compared with the control group,the difference was not significant preoperatively and 3 months after operation(P>0.05).(4)There was no significant difference in blood flow density during preoperation,1 month and 3 months after operation(P>0.05).(5)In terms of RNFL thickness,1 month and 3 months after operation,the thickness was reduced compared with preoperation(P<0.05).However,there was no significant difference between 1 month and 3 months after operation(P>0.05).4.?2 quadrants groups in terms of blood flow density and RNFL thickness:(1)Preoperatively,1 month and 3 months after operation blood flow densities in the whole image,peripapillary and in the superior,inferior,nasal and temporal quadrant were compared with those in the control group respectively,blood flow density decreased(P<0.05).(2)Preoperatively and 3 months after operation,the blood flow density in the inside disc was lower compared with the control group,(P<0.05),but 1 month after operation the blood flow density compared with the control group,the difference was not statistically significant(P>0.05).(3)There was no significant difference in blood flow density during preoperation,1 month and 3 months after operation(P>0.05).(4)In terms of RNFL thickness,3 months after operation,the thickness was reduced compared with preoperation(P<0.05).However,preoperatively and 3 months after operation,there was no significant difference compared with 1 month after surgery respectively(P>0.05).5.>2 quadrants groups and ?2 quadrants groups in terms of blood flow density and RNFL thickness:(1)In the whole image,preoperatively the blood flow density was lower in ?2 quadrants groups than in >2 quadrants groups(P<0.05),and 1 month and 3 months after operation there was no statistical difference between the two groups(P>0.05).(2)In the nasal quadrant,preoperatively and 3 months after operation the blood flow density were lower in ?2 quadrants groups than in >2 quadrants groups(P<0.05),and 1 month after operation there was no statistical difference between the two groups(P>0.05).(3)In the temporal quadrant,1 month after operation the blood flow density was lower in ?2 quadrants groups than in >2 quadrants groups(P<0.05),and preoperatively and 3 months after operation there was no statistical difference between the two groups(P>0.05).(4)The blood flow density in the peripapillary,inside disc,superior and inferior quadrant,was no statistical difference between the two groups during preoperation,1 month and 3 months after operation(P>0.05).(5)In terms of RNFL thickness,there was no statistical significance between the two groups(P>0.05).Conclusions:1.The BCVA of the vast majority of patients have been improved after surgery,and with the increase of filling time and the retina gradually fully reset,the BCVA of most patients can be further improved.2.Preoperatively,1 month and 3 months after surgery,blood flow density decrease in most areas of the optic disc,while silicone oil tamponade and the range of detachment have a small effect on blood flow density.3.Within 3 months after surgery,silicone oil tamponade makes the average RNFL thickness around the optic disc thinner,and the range of detachment has a less effect on RNFL thickness. |
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