Early vascular changes after silicone oil removal using optical coherence tomography angiography

Area of Science:

• Ophthalmology
• Retinal Surgery
• Vascular Imaging

Background:

• Rhegmatogenous retinal detachment often requires silicone oil (SO) tamponade.
• Vascular changes in the macula and peripapillary regions are a concern during SO tamponade.
• Understanding these vascular changes is crucial for patient outcomes.

Purpose of the Study:

• To evaluate vascular changes in the macular and peripapillary regions before and after silicone oil removal.
• To compare vascular density in eyes with SO tamponade versus gas tamponade.
• To investigate the correlation between vascular changes and visual acuity.

Main Methods:

• Single-center case series including patients undergoing SO removal.
• Control group: patients undergoing pars plana vitrectomy with C3F8 gas tamponade.
• Optical coherence tomography angiography (OCTA) assessed superficial vessel density (SVD) and perfusion density (SPD).
• Best-corrected visual acuity (BCVA) measured using LogMAR.

Main Results:

• SO tamponade eyes showed lower macular SVD and SPD compared to controls.
• Peripapillary SVD and SPD were reduced in SO tamponade eyes (except central area).
• Macular SVD and SPD improved significantly after SO removal, but peripapillary SVD/SPD did not.
• Post-operative BCVA decreased and correlated negatively with macular SVD and SPD.

Conclusions:

• Silicone oil tamponade is associated with decreased macular and peripapillary vascular density.
• Macular vascular density improves after silicone oil removal.
• These vascular changes may contribute to reduced visual acuity during or after silicone oil tamponade.