Analysis of Retinal Layers’ Thickness and Vascular Density after Successful Scleral Buckle Surgery

Purpose: To investigate retinal layers’ thickness and vascular density after successful scleral buckle surgery using the optical coherence tomography angiography (OCTA) method. Methods: In this prospective interventional case‑control study, 24 patients with macular‑off rhegmatogenous retinal detachment (RRD) were included after performing successful reattachment by scleral buckling. Retinal layers’ thickness and vascular density were assessed in the patients using the OCTA method compared to normal fellow eyes as controls 10 months postoperation. Results: Inner retinal layers showed no significant difference, but there was a significant reduction in outer central 1‑mm retinal layers’ thickness. Outer plexiform‑Bruch’s membrane (153.1 ± 24.3 μm vs. 166.2 ± 15.1 μm, P = 0.003) and ellipsoid zone to Bruch’s membrane (51.25 ± 9.3 μm vs. 57.35 ± 3.8 μm, P = 0.009) were thinner in the operated eyes compared to fellow eyes. Vascular density within a 300 μm wide region around the foveal avascular zone (FAZ) (foveal density‑300) was significantly lower in the detached eyes (46.28% ± 7.12% vs. 51.01% ± 4.73%, P = 0.016), however, there was no difference in superficial and deep vascular density at 1‑mm central circle. Superficial parafoveal vascular density was lower in the operated eyes (46.24% ± 5.30% vs. 49.52% ± 5.93%, P = 0.026) with no significant difference in deep parafoveal vascular density (49.93 ± 4.29% vs. 51.88% ± 4.79%, P = 0.137). There was no difference in FAZ area and perimeter between the two groups. Conclusions: Complete recovery of retinal thickness and vascular density did not achieve in the patients with RRD even after 10 months of reattachment by scleral buckling surgery. Superficial capillary vascular density was more affected than deep vascular density almost in the parafoveal area.