The changes and correlation between foveal avascular zone size and visual acuity in patients with rhegmatogenous retinal detachment_Chinese Journal of Ocular Fundus Diseases

Authors：

Fu Yan ^1,2 ,  Chen Song ^2,3 , Hu Zhaohui ¹ , Zhang Yueling ¹ , Li Liying ¹ , Chen Qiang ¹

1. Department of Ophtalmology, Baoding First Central Hospital, Baoding 071000, China;
2. Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin 300020, China;
3. Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Clinical, College of Ophthalmology Tianjin Medical University, Tianjin 300020, China;

Corresponding?author：

Chen Song, Email: chensong9999@126.com

Keywords：

Retinal detachment/surgery; Tomography, optical coherence; Foveal avascular zone

DOI：

10.3760/cma.j.cn511434-20190917-00293

Video：

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Objective To evaluate the changes in foveal avascular zone (FAZ) size and foveal microstructures in patients with rhegmatogenous retinal detachment (RRD) and to analyze the correlation between FAZ size, foveal microstructure changes and visual outcomes.Methods A retrospective study. From January 2017 to January 2019, 79 RRD patients (79 eyes) diagnosed in Department of Ophthalmology in Baoding First Central Hospital were included in the study. The patients were divided into macula-off group (51 eyes), macula-on group (28 eyes). The unaffected fellow eyes were used as a control group. The retinas were reattachment in all eyes after first standard 23G PPV combined with silicone oil filling. Before and 3 months after surgery, all patients underwent a comprehensive ophthalmologic examination, including the measurement of BCVA and OCT angiography (OCTA) examination. The BCVA examination was performed using the international standard visual acuity chart, which was converted into logMAR visual acuity. The FAZ areas were evaluated with OCTA in the superficial capillary plexus layers by using 3 mm×3 mm images of the macular. The following postoperative foveal microstructures were evaluated:epiretinal membranes, macular edema, subretinal fluids, integrity of ellipsoidal zone and external limiting membrane. Pearson correlation analysis was used to analyze the correlation between FAZ area and BCVA. The correlation between macular microstructures and BCVA was analyzed by Spearman correlation analysis.Results At 3 months after the removal of silicone oil, the FAZ area in the macula-off group, macula-on group and the control group were 0.447±0.041, 0.409±0.034, 0.335±0.027 mm², respectively. Compared with the control group, the FAZ area in the macula-off group and macula-on group were enlarged, the difference was statistically significant (F=184.148, P＜0.05). The logMAR BCVA in the macula-off group and macula-on group were 0.800±0.180 and 0.386±0.160, respectively. There was significant difference in ellipsoidal zone rupture between the two groups (χ²=7.577, P=0.006). The results of correlation analysis showed that the area of FAZ and the incidence of ellipsoidal zone fracture after surgery were positively correlated with BCVA after surgery (r=0.329, 0.290; P=0.003, 0.010).Conclusions The FAZ area of RRD is enlarged after surgery. FAZ area and ellipsoid zone fracture are positively correlated with BCVA after surgery.

Citation： Fu Yan, Chen Song, Hu Zhaohui, Zhang Yueling, Li Liying, Chen Qiang. The changes and correlation between foveal avascular zone size and visual acuity in patients with rhegmatogenous retinal detachment. Chinese Journal of Ocular Fundus Diseases, 2020, 36(5): 354-357. doi: 10.3760/cma.j.cn511434-20190917-00293 Copy

1.	Lina G, Xuemin Q, Qinmei W, et al. Vision-related quality of life, metamorphopsia, and stereopsis after successful surgery for rhegmatogenous retinal detachment[J]. Eye (Lond), 2016, 30(1): 40-45. DOI: 10.1038/eye.2015.171.
2.	Park DH, Choi KS, Sun HJ, et a1. Factors associated with visual outcome after macula-off rhegmatogenous retinal detachment surgery[J]. Retina, 2018, 38(1): 137-147. DOI: 10.1097/IAE.0000000000001512.
3.	Delolme MP, Dugas B, Nicot F, et al. Anatomical and functional macular changes after rhegmatogenous retinal detachment with macula off[J]. Am J Ophthalmol, 2012, 153(1): 128-136. DOI: 10.1016/j.ajo.2011.06.010.
4.	Karacorlu M, Sayman Muslubas I, Hocaoglu M, et a1. Correlation between morphological changes and functional outcomes of recent-onset macula-off rhegmatogenous retinal detachment: prognostic factors in rhegmatogenous retinal detachment[J]. Int Ophthalmol, 2018, 38(3): 1275-1283. DOI: 10.1007/s10792-017-0591-6.
5.	SamaraWA, Say EA, Khoo CT, et al. Correlation of foveal avascular zone size with foveal morphology in normal eyes using optical coherence tomography angiography[J]. Retina, 2015, 35(11): 2188-2195. DOI: 10.1097/IAE.0000000000000847.
6.	Sugahara M, Miyata M, Ishihara K, et al. Optical coherence tomography angiography to estimate retinal blood flow in eyes with retinitis pigmentosa[J/OL]. Sci Rep, 2017, 7: 46396[2017- 04-13].https://www.nature.com/articles/srep46396. DOI: 10.1038/srep46396.
7.	Agemy SA, Scripsema NK, Shah CM, et al. Retinal vascular perfusion density mapping using optical coherence tomography angiography in normal and diabetic retinopathy patients[J]. Retina, 2015, 35(11): 2353-2363. DOI: 10.1097/IAE.0000000000000862.
8.	禹海, 高明宏, 李穎, 等. 累及黃斑的孔源性視網膜脫離手術后黃斑下積液眼黃斑形態變化與視力預后的關系及其影響因素分析[J]. 中華眼底病雜志, 2013, 29(2): 136-141. DOI: 10.3760/cma.j.issn.1005-1015.2013.02.005.Yu H, Gao MH, Li Y, et al. Relationship between morphologic macular changes and visual outcome in eyes with persistent submacular fluid after surgery for macula-off rhegmatogenous retinal detachment and relevant factors of persistent submacular fluid[J]. Chin J Ocul Fundus Dis, 2013, 29(2): 136-141. DOI: 10.3760/cma.j.issn.1005-1015.2013.02.005.
9.	陳鈺虹, 朱鴻, 王泓. 孔源性視網膜脫離術后視功能恢復的影響因素[J]. 眼科新進展, 2018, 38(4): 396-400. DOI: 10.13389/j.cnki.rao.2018.0093.Chen YH, Zhu H, Wang H. Influencing factors for the recovery of visual function following rhegmatogenous retinal detachment repair[J]. Rec Adv Ophthalmol, 2018, 38(4): 396-400. DOI: 10.13389/j.cnki.rao.2018.0093.
10.	Joe SG, Kim YJ, Chae JB, et a1. Structural recovery of the detached macula after retinal detachment repair as assessed by optical coherence tomography[J]. Korean J Ophthalmol, 2013, 27(3): 178-185. DOI: 10.3341/kjo.2013.27.3.178.
11.	Hisatomi T, Sakamoto T, Goto Y, et al. Critical role of photoreceptor apoptosis in functional damage after retinal detachment[J]. Curr Eye Res, 2002, 24(3): 161-172. DOI: 10.1076/ceyr.24.3.161.8305.
12.	Yu J, Jiang C, Wang X, et al. Macular perfusion in healthy Chinese: an optical coherence tomography angiogram study[J]. Invest Ophthalmol Vis Sci, 2015, 56(5): 3212-3217. DOI: 10.1167/iovs.14-16270.
13.	Spaide RF, Klancnik JM, Cooney MJ. Retinal vascular layers imaged by fluorescein angiography and optical coherence tomography angiography[J]. JAMA Ophthalmol, 2015, 133(1): 45-50. DOI: 10.1001/jamaophthalmol.2014.3616.
14.	Hwang TS, Jia Y, Gao SS, et al. Optical coherence tomography angiography features of diabetic retinopathy[J]. Retina, 2015, 35(11): 2371-2376. DOI: 10.1097/IAE.0000000000000716.
15.	Uji A, Balasubramanian S, Lei J, et al. Choriocapillaris imaging using multiple en face optical coherence tomography angiography image averaging[J]. JAMA Ophthalmol, 2017, 135(11): 1197-1204. DOI: 10.1001/jamaophthalmol.2017.3904.
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17.	Yoshikawa Y, Shoji T, Kanno J., et al Evaluation of microvascular changes in the macular area of eyes with rhegmatogenous retinal detachment without macular involvement using swept-source optical coherence tomography angiography[J]. Clin Ophthalmol, 2018, 12: 2059-2067. DOI: 10.2147/OPTH.S177933.
18.	Yui N, Kunikata H, Aizawa N, et al. Optical coherence tomography angiography assessment of the macular capillary plexus after surgery for macula-off rhegmatogenous retinal detachment[J]. Graefe's Arch Clin Exp Ophthalmol, 2019, 257(1): 245-248. DOI: 10.1007/s00417-018-4133-3.

1. Lina G, Xuemin Q, Qinmei W, et al. Vision-related quality of life, metamorphopsia, and stereopsis after successful surgery for rhegmatogenous retinal detachment[J]. Eye (Lond), 2016, 30(1): 40-45. DOI: 10.1038/eye.2015.171.
2. Park DH, Choi KS, Sun HJ, et a1. Factors associated with visual outcome after macula-off rhegmatogenous retinal detachment surgery[J]. Retina, 2018, 38(1): 137-147. DOI: 10.1097/IAE.0000000000001512.
3. Delolme MP, Dugas B, Nicot F, et al. Anatomical and functional macular changes after rhegmatogenous retinal detachment with macula off[J]. Am J Ophthalmol, 2012, 153(1): 128-136. DOI: 10.1016/j.ajo.2011.06.010.
4. Karacorlu M, Sayman Muslubas I, Hocaoglu M, et a1. Correlation between morphological changes and functional outcomes of recent-onset macula-off rhegmatogenous retinal detachment: prognostic factors in rhegmatogenous retinal detachment[J]. Int Ophthalmol, 2018, 38(3): 1275-1283. DOI: 10.1007/s10792-017-0591-6.
5. SamaraWA, Say EA, Khoo CT, et al. Correlation of foveal avascular zone size with foveal morphology in normal eyes using optical coherence tomography angiography[J]. Retina, 2015, 35(11): 2188-2195. DOI: 10.1097/IAE.0000000000000847.
6. Sugahara M, Miyata M, Ishihara K, et al. Optical coherence tomography angiography to estimate retinal blood flow in eyes with retinitis pigmentosa[J/OL]. Sci Rep, 2017, 7: 46396[2017- 04-13].https://www.nature.com/articles/srep46396. DOI: 10.1038/srep46396.
7. Agemy SA, Scripsema NK, Shah CM, et al. Retinal vascular perfusion density mapping using optical coherence tomography angiography in normal and diabetic retinopathy patients[J]. Retina, 2015, 35(11): 2353-2363. DOI: 10.1097/IAE.0000000000000862.
8. 禹海, 高明宏, 李穎, 等. 累及黃斑的孔源性視網膜脫離手術后黃斑下積液眼黃斑形態變化與視力預后的關系及其影響因素分析[J]. 中華眼底病雜志, 2013, 29(2): 136-141. DOI: 10.3760/cma.j.issn.1005-1015.2013.02.005.Yu H, Gao MH, Li Y, et al. Relationship between morphologic macular changes and visual outcome in eyes with persistent submacular fluid after surgery for macula-off rhegmatogenous retinal detachment and relevant factors of persistent submacular fluid[J]. Chin J Ocul Fundus Dis, 2013, 29(2): 136-141. DOI: 10.3760/cma.j.issn.1005-1015.2013.02.005.
9. 陳鈺虹, 朱鴻, 王泓. 孔源性視網膜脫離術后視功能恢復的影響因素[J]. 眼科新進展, 2018, 38(4): 396-400. DOI: 10.13389/j.cnki.rao.2018.0093.Chen YH, Zhu H, Wang H. Influencing factors for the recovery of visual function following rhegmatogenous retinal detachment repair[J]. Rec Adv Ophthalmol, 2018, 38(4): 396-400. DOI: 10.13389/j.cnki.rao.2018.0093.
10. Joe SG, Kim YJ, Chae JB, et a1. Structural recovery of the detached macula after retinal detachment repair as assessed by optical coherence tomography[J]. Korean J Ophthalmol, 2013, 27(3): 178-185. DOI: 10.3341/kjo.2013.27.3.178.
11. Hisatomi T, Sakamoto T, Goto Y, et al. Critical role of photoreceptor apoptosis in functional damage after retinal detachment[J]. Curr Eye Res, 2002, 24(3): 161-172. DOI: 10.1076/ceyr.24.3.161.8305.
12. Yu J, Jiang C, Wang X, et al. Macular perfusion in healthy Chinese: an optical coherence tomography angiogram study[J]. Invest Ophthalmol Vis Sci, 2015, 56(5): 3212-3217. DOI: 10.1167/iovs.14-16270.
13. Spaide RF, Klancnik JM, Cooney MJ. Retinal vascular layers imaged by fluorescein angiography and optical coherence tomography angiography[J]. JAMA Ophthalmol, 2015, 133(1): 45-50. DOI: 10.1001/jamaophthalmol.2014.3616.
14. Hwang TS, Jia Y, Gao SS, et al. Optical coherence tomography angiography features of diabetic retinopathy[J]. Retina, 2015, 35(11): 2371-2376. DOI: 10.1097/IAE.0000000000000716.
15. Uji A, Balasubramanian S, Lei J, et al. Choriocapillaris imaging using multiple en face optical coherence tomography angiography image averaging[J]. JAMA Ophthalmol, 2017, 135(11): 1197-1204. DOI: 10.1001/jamaophthalmol.2017.3904.
16. Woo JM, Yoon YS, Woo JE, et al. Foveal avascular zone area changes analyzed using OCT angiography after successful rhegmatogenous retinal detachment repair[J]. Curr Eye Res, 2018, 43(5): 674-678. DOI: 10.1080/02713683.2018.1437922.
17. Yoshikawa Y, Shoji T, Kanno J., et al Evaluation of microvascular changes in the macular area of eyes with rhegmatogenous retinal detachment without macular involvement using swept-source optical coherence tomography angiography[J]. Clin Ophthalmol, 2018, 12: 2059-2067. DOI: 10.2147/OPTH.S177933.
18. Yui N, Kunikata H, Aizawa N, et al. Optical coherence tomography angiography assessment of the macular capillary plexus after surgery for macula-off rhegmatogenous retinal detachment[J]. Graefe's Arch Clin Exp Ophthalmol, 2019, 257(1): 245-248. DOI: 10.1007/s00417-018-4133-3.

Chinese Journal of Ocular Fundus Diseases

The changes and correlation between foveal avascular zone size and visual acuity in patients with rhegmatogenous retinal detachment

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