Abstract
Current imaging techniques based on optical coherence tomography (OCT)
angiography are useful for observing different retinal microcirculation patterns. The
primary purpose of this chapter was to describe the functional, structural, and serial
perfusion postoperative outcomes of successfully reattached macula-off tractional
retinal detachment (TRD). Patients who underwent a successful diabetic vitrectomy
were analyzed. The mean differences between the preoperative best-corrected visual
acuity (BCVA), 3-month BCVA, and final postoperative BCVA were statistically
significant (p < 0.05). The duration of vision loss before surgery was 11.6 ± 2.3 weeks
(mean ± standard deviation (SD)).
The mean duration (± SD) of the resolution of macular detachment was 3.6 ± 1.7 weeks
in the pure macular TRD group and 1.8 ± 0.8 weeks in the combined tractional and
rhegmatogenous macular detachment (p < 0.05) group. The mean follow-up duration of
all patients was 11.4 ± 5.7 months (mean ± SD). Longitudinal multimodal imaging tests
revealed abnormal superficial and deep microcirculation patterns with multiple
microabnormalities in the foveal avascular zone and different but distinct areas of the
non-perfused macula in different OCT angiography slabs. Additionally, disorganization of the retinal inner layers and chronic ischemic macular edema were observed in 82%
of eyes examined using the spectral domain (SD) OCT. Therefore, these data suggest
that despite the successful anatomical reattachment of the macula, long-term
postoperative microcirculatory abnormalities were detected in both groups; however,
these abnormalities were predominantly accompanied by severe persistent ischemia in
the recurrent TRD group due to the presence of multiple microcirculatory defects.
Keywords: Choriocapillaris subfoveal plexus, Deep vascular plexus, Disorganization of the retinal inner layers, Long-term proliferative diabetic retinopathy complications, Macula-off tractional retinal detachment, Optical coherence tomography angiography, Macular perfusion indices, Perfusion microcirculatory abnormalities, Ischemic macula, Chromatic visual field testing, Microperimetry, Multifocal electroretinography, Secondary complicated retinal detachment, Superficial vascular plexus, Vessel density.