Lyssek-Boroń Anita, Wylęgała Adam, Krysik Katarzyna, Janiszewska-Bil Dominika, Wylęgała Edward, Grabarek Beniamin Oskar, Dobrowolski Dariusz
Department of Ophthalmology, Faculty of Medicine in Zabrze, University of Technology, 41-800 Zabrze, Poland.
Trauma Centre, Department of Ophthalmology, St. Barbara Hospital, 41-200 Sosnowiec, Poland.
J Clin Med. 2021 Oct 28;10(21):5054. doi: 10.3390/jcm10215054.
The aim of this study was to investigate the changes in the retinal capillary plexuses in patients after pars plana vitrectomy (PPV), which is used for the treatment of rhegmatogenous retinal detachment (RRD). In this study, we included the results of 114 patients who underwent PPV after total retinal detachment (RRD; retinal detachment group). It should be kept in mind that to qualify for the study group, there was a condition that retinal detachment be only present in one eye, allowing the fellow healthy eye to be used for the control group, and the study, therefore, did not include cases where retinal detachment occurred binocularly. Optical coherence tomography (OCT) and OCT-A images were taken at 9 ± 2 months (median 10 months) after the surgery, with the study conducted in the years 2017-2019. OCT was used to examine the external limiting membrane (ELM), central macular thickness (CMT) and retinal nerve fiber layer (RNFL), while OCT-angiography (OCT-A) was used to examine the extent of the foveal avascular zone (FAZ) in the deep and superficial capillary plexuses. Changes in the FAZ area of the superficial plexus (SCP) between the study and control groups were analyzed over 346 ± 50 days. In our study, we observed changes in the FAZ area between the RRD and control groups in the SCP (203.65 ± 31.69 μm vs. 215.30 ± 35.82 μm; = 0.28733) and DCP (284.79 ± 35.82 µm vs. 336.84 ± 32.23 µm; = 0.00924). Changes in the RNFL thickness between the study and control groups over 346 ± 50 days were as follows: 90.15 μm vs. 82.44 μm; = 0.19773. Disruption of the external limiting membrane was observed in 78.95% (90 eyes) of the study group. In the control group, it was undamaged, and no integrity disorder was observed. In the RRD, changes occurred in the FAZ of both the SCP and the DCP, which reduced the extent of this zone, an effect that was more pronounced in DCPs. A better understanding of the anatomical and hemodynamic changes taking place in the retina after macula-off RRD might be helpful in answering the question as to why BCVA in these cases is "only" or "as much as" from 0.4 to 0.1, namely, that it might be related to changes in the neurosensory retina after macular peeling.
本研究的目的是调查用于治疗孔源性视网膜脱离（RRD）的玻璃体切割术（PPV）后患者视网膜毛细血管丛的变化。在本研究中，我们纳入了114例全视网膜脱离（RRD；视网膜脱离组）后接受PPV的患者的结果。需要记住的是，要符合研究组的条件，有一个条件是视网膜脱离仅存在于一只眼睛中，从而使对侧健康眼睛可用于对照组，因此，本研究不包括双眼发生视网膜脱离的病例。在2017 - 2019年进行的这项研究中，于手术后9±2个月（中位数10个月）拍摄光学相干断层扫描（OCT）和OCT血管造影（OCT - A）图像。OCT用于检查外界膜（ELM）、中心黄斑厚度（CMT）和视网膜神经纤维层（RNFL），而OCT血管造影（OCT - A）用于检查深层和浅层毛细血管丛中黄斑无血管区（FAZ）的范围。在346±50天内分析研究组和对照组之间浅层毛细血管丛（SCP）的FAZ面积变化。在我们的研究中，我们观察到RRD组和对照组之间SCP的FAZ面积变化（203.65±31.69μm对215.30±35.82μm；P = 0.28733）以及深层毛细血管丛（DCP）的FAZ面积变化（284.79±35.82μm对336.84±32.23μm；P = 0.00924）。在346±50天内研究组和对照组之间RNFL厚度的变化如下：90.15μm对82.44μm；P = 0.19773。研究组中78.95%（90只眼）观察到外界膜破坏。在对照组中，其未受损，未观察到完整性紊乱。在RRD中，SCP和DCP的FAZ均发生变化，这减小了该区域的范围，这种效应在DCP中更明显。更好地了解黄斑脱离性RRD后视网膜发生的解剖和血流动力学变化可能有助于回答为什么这些病例中的最佳矫正视力（BCVA）“仅”或“高达”0.4至0.1的问题，即这可能与黄斑剥脱后神经感觉视网膜的变化有关。
