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FRACTAL DIMENSION AND OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY FEATURES OF THE CENTRAL MACULA AFTER REPAIR OF RHEGMATOGENOUS RETINAL DETACHMENTS

Agarwal, Aniruddha, MD*; Aggarwal, Kanika, MS*; Akella, Madhuri, MBBS*; Agrawal, Rupesh, FRCS†,‡; Khandelwal, Neha, MD; Bansal, Reema, MS*; Singh, Ramandeep, MS*; Gupta, Vishali, MS* for the OCTA Study Group

doi: 10.1097/IAE.0000000000002276
Original Study: PDF Only

Purpose: Patients with macula-off rhegmatogenous retinal detachments (RRDs) may have suboptimal visual recovery, despite successful reattachment due to various reasons. This study was performed to evaluate the retinal microvasculature in subjects undergoing surgery for RRD using optical coherence tomography angiography.

Methods: In this case–control study, the analysis of optical coherence tomography angiography findings of 19 eyes of 19 patients (15 men) who underwent RRD surgery at a tertiary institute were compared with 19 eyes of 19 age- and sex-matched healthy subjects with no known ocular disease. 3 × 3-mm optical coherence tomography angiography scans were obtained at 3 months postoperatively and analyzed. Optical coherence tomography angiography images of patients with RRD and control subjects were analyzed for capillary density index and fractal dimensions.

Results: Mean age of the patients was 40.21 years, and the mean age of controls was 43.73 years. Eight eyes underwent scleral buckling alone, and 11 eyes underwent primary vitrectomy with gas tamponade (C3F8 gas) for macula-off RRD. None of the eyes had redetachment during the follow-up at 3 months. Mean capillary density index among patients was 33.28% ± 0.99% and 34.06% ± 2.22% in the superficial and deep retinal plexuses, respectively, compared with 36.11% ± 1.29% and 37.52% ± 1.24% among controls (P < 0.001). The mean fractal dimension was lower among subjects compared with controls (1.46 vs. 1.61 in the superficial plexus, P < 0.001; 1.58 vs. 1.64 in the deep plexus, P < 0.001).

Conclusion: Optical coherence tomography angiography demonstrates significant reduction in mean capillary density index and fractal dimension in patients after surgery for RRD in our patients. Thus, reduction in vascular perfusion and branching pattern identified using novel analysis techniques on optical coherence tomography angiography images may provide an insight into the reasons for suboptimal visual gain after RRD surgery.

Optical coherence tomography angiography was performed postoperatively among subjects who underwent surgery for rhegmatogenous retinal detachment. These images were compared with healthy control subjects. Vascular density and fractal dimensions were significantly lower among patients. This finding indicates that suboptimal visual gain after surgery may be due to reduction in perfusion.

*Department of Ophthalmology, Advanced Eye Center, Post Graduate Institute of Medical Education and Research, Chandigarh, India;

Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore; and

Department of Ophthalmology, Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom.

Reprint requests: Vishali Gupta, MS, Ophthalmology, Advanced Eye Center, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh 160012, India; e-mail: vishalisara@yahoo.co.in

Supported in part by a grant from Department of Biotechnology, Ministry of Health, India, for the development of Centre of Excellence at the Advanced Eye Center, PGIMER, Chandigarh.

None of the authors has any financial/conflicting interests to disclose.

The authors alone are responsible for the content and preparation of this manuscript.

© 2018 by Ophthalmic Communications Society, Inc.