Retinal microvascular and optic nerve circulation changes analyzed using optic cohorense tomography anjiografi after successful retinal detachment repair

Purpose: We aimed to investigate changes in retinal microvascular structure and optic nerve head circulation in eyes undergoing surgical intervention (Pars Plana Vitrectomy, scleral buckling) due to retinal detachment using Optical Coherence Tomography Angiography (OCTA) at postoperative 1st and 3rd months. Method: Between May 2022 and June 2023, a total of 32 patients who underwent retinal detachment surgery (scleral buckling or pars plana vitrectomy) in one eye at the Department of Ophthalmology, Faculty of Medicine, Celal Bayar University, and achieved anatomical success in the surgery, were included. Retinal microvascular structures and optic nerve head vessel densities were evaluated using Optical Coherence Tomography Angiography (OCTA) at postoperative months 1 and 3. The healthy eyes of the patients were taken as the control group. OCTA parameters of the healthy eyes and surgically treated eyes were analyzed and compared. Results: In the study, 12 patients were female (37.5%), and 20 patients were male (62.5%). The mean age of the patients was 55.75±15.83 years. Among the eyes included in the study, 20 (62.5%) had macula involvement, and 12 (37.5%) did not have macula involvement. In our study, the OCTA data of the healthy fellow eyes of patients who underwent surgery for retinal detachment in one eye were compared. At postoperative month 1, superficial capillary plexus (SCP) total density, SCP lower half density, and SCP perifoveal vascular density were found to be statistically significantly lower compared to the control group (p<0.0001). Deep capillary plexus (DCP) values were lower than the control group, but this difference did not reach statistical significance. At postoperative month 3, when OCTA data were compared with the control group, there was a decrease in DCP lower half area density, DCP parafoveal density, SCP total density, SCP upper half area density, SCP parafoveal density, and SCP perifoveal density values compared to the healthy fellow eye, and this difference was statistically significant (respectively, p: 0.05, p: 0.001, p: 0.001, 0.003, p: 0.002, p: 0.001, p: 0.003). Patients who underwent successful surgery for retinal detachment showed an increase in foveal avascular zone (FAZ) area according to OCTA measurements at postoperative month 1. When FAZ areas at postoperative months 1 and 3 were compared, a narrowing of the FAZ area was observed at postoperative month 3, and this difference was statistically significant (p: 0.004). At postoperative months 1 and 3, there was a statistically significant decrease in optic nerve head vascular density values measured with the OCTA device compared to the control group (p<0.05). Conclusion: In eyes that have undergone anatomically successful surgery due to retinal detachment, a decrease in both superficial capillary plexus (SCP) and deep capillary plexus (DCP) vascular density values was observed in postoperative 1st and 3rd month OCTA measurements compared to the healthy fellow eye. When OCTA measurements at postoperative month 1 and month 3 were compared for patients who underwent successful surgery, a narrowing of the foveal avascular zone (FAZ) area was observed at postoperative month 3. A decrease in optic nerve head vascular density values compared to the control group was observed at postoperative months 1 and 3. Patients who underwent successful surgery for retinal detachment showed a decrease in choriocapillaris blood flow values at postoperative months 1 and 3 compared to the control group.