Analysis Of The Factors Influencing Visual Function After Repair Of Retinal Detachment

Objective: to study the influencing factors of visual function after repair of rhegmatogenous retinal detachment(RRD).Methods: Collected the clinical data of patients with RRD who underwent successfully surgical treatment at the Second hospital of Jilin University by the same one doctor in August 2018-October 2019.Analyzed the result of patients' gender,age,eye,disease duration,preoperative intraocular pressure(IOP),axial lengths(AL),the best corrective visual acuity(BCVA),and the OCTA examination data by statistics.Results: The primary reattachment rate of retina is about 93.17%.21 eyes of 21 patients were included in the study,and 17 eyes of 9 normal persons were included in the blank control group.11 eyes underwent pars plana vitrectomy(PPV)(male to female ratio was 7:4;right eye to left eye ratio was 5:6;The average age was 55.45±6.85 years;Preoperative disease duration was 32.36±32.04 days),and 10 eyes underwent scleral buckling(SB)(male to female ratio was 7:3;left eye ratio was 6:4;The average age was 34.40±13.02 years;Preoperative disease duration was 28.60±34.30 days).the age of patients undergoing SB is younger than PPV(P<0.01),and the BCVA at 6 months after operation of patients undergoing SB(0.15±0.10 log MAR)is better than the PPV group(0.27±0.12 log MAR,P<0.05).In the PPV group,the thickness of inner retina is lower than that of the other eye and the normal eye(P<0.01).The thickness of the outer retina at 3 months is lower than that of the control group(P<0.01),and increased at 6 months,which has no significant statistical difference with the contralateral eye and the normal eye(P>0.05).In the SB group,only the thickness of the outer retina decreases after operation(P<0.05).The reduced of vessel density was observed in both surgical groups(P<0.05),and the deep vessel density(DVD)in the PPV group was lower than that of the SB group(P<0.01).The result of Pearson Correlation Coefficient analysis indicated that the change of SVD and DVD after the operation was positively correlated with the thickness of the inner retina(r>0.5,P<0.01).The result of Single-factor correlation demonstrated that the preoperative disease duration and the preoperative BCVA were significant influencing factors of the postoperative BCVA(r>0.6,P<0.05),meanwhile,Multiple linear regression analysis showed that the changes of retinal thickness and vessel density also were the influencing factors of postoperative BCVA(P<0.05).The foveal avascular zone(FAZ)area at 6 months after operation was only positively correlated with that at 3 months(r>0.7,P<0.01).Conclusion: Surgery is an effective treatment for rhegmatogenous retinal detachment.the age of patients undergoing SB is younger than PPV,and the BCVA at 6 months after operation of patients undergoing SB is better than the PPV group.There is a common phenomenon that the reduced of outer retinal thickness and capillary density index of the inner retina are observed in both surgical groups,and vitrectomy with silicone oil as the tamponade has a greater influence than scleral buckling on the retinal structure.The preoperative disease duration,the preoperative BCVA,and the changes of the outer retinal thickness and vessel density are the direct influencing factors of the postoperative BCVA.