Change in retinal and choroidal microvascular structures after rhegmatogenous retinal detachment surgery and effects on visual recovery.

Purpose: To investigate changes in retinal and choroidal microvascular structures in the macular region after surgery for rhegmatogenous retinal detachment (RRD) and their relationship to visual function at 3months.

Methods: This prospective, cross-sectional study included 37 eyes of 37 patients who underwent surgery for RRD (pneumatic retinopexy and/or pars plana vitrectomy). All patients underwent a comprehensive ophthalmologic examination, including measurement of best-corrected visual acuity (BCVA, logMAR), anterior segment and fundus examination, and optical coherence tomography angiography (OCTA) imaging 3months postoperatively. The healthy fellow eyes formed the control group. OCTA was used for the assessment of macular vessel density (VD), foveal avascular zone (FAZ), central macular thickness, and choroidal and outer retinal flow rates.

Results: The findings showed that the VD of the superficial and deep capillary plexuses were lower in the RRD group compared to the control group (P=0.012; P<0.001). The FAZ was larger in the RRD group (P=0.035). The choroidal flows in the 1 and 3mm were lower in the RRD group (P<0.001). Superficial FAZ area and choroidal flow rate (1 and 3mm areas) were moderately negatively correlated with BCVA (P=0.008; P=0.035; P=0.008).

Conclusions: Our study demonstrated that the FAZ was larger, and the choroidal flow rate was lower, in the RRD group compared to the control group. Choroidal flow rate was negatively correlated with postoperative BCVA. Ischemic events resulting from the RRD were likely the reason for these changes.