Preretinal abnormal tissue before and after pars plana vitrectomy in macula-on rhegmatogenous retinal detachment: a multimodal imaging study.

Abstract

To quantitatively explore preretinal abnormal tissue (PAT) in macula-on rhegmatogenous retinal detachment (RRD) before and after surgery. In this case-series study, PAT was detected by en-face optical coherence tomography images with custom slabs in eyes that underwent pars plana vitrectomy and SF6 for macula-on RRD.Main outcome measures were PAT area at baseline, 3-month and 6-month follow-up, and its relative change. Associations between PAT and foveal avascular zone (FAZ) at superficial capillary plexus (SCP), RRD area, retinal tear (RT) area and endolaser area were investigated. 36 macula-on eyes RRD were included in the analysis. Significant PAT growth was registered from baseline until 6 months (p<0.001). Baseline PAT area correlated with RT area (r=0.54, p=0.001). Significant correlation between relative change in PAT and relative change in FAZ SCP was found. The multivariable regression model showed a statistically significant association between Endolaser area (cm²) and relative changes in PAT (p=0.004). Our study found that despite good retinal reattachment, PAT proliferates over months with vascular changes. Endolaser area has a major influence on PAT growth, without impact on best-corrected visual acuity. Additional knowledge about pathophysiological mechanisms of growth could help understanding which surgical approach may limit PAT extension and future secondary epiretinal membrane.