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Association of macular and choroidal perfusion with long-term visual outcomes after macula-off rhegmatogenous retinal detachment
  1. Jacqueline Chua1,2,3,
  2. Mengyuan Ke3,
  3. Bingyao Tan3,4,
  4. Alfred Tau Liang Gan1,
  5. Laurence S Lim2,
  6. Gavin SW Tan2,
  7. Shu Yen Lee2,
  8. Edmund Wong2,
  9. Leopold Schmetterer2,3,4,5,6,7,
  10. Ning Cheung2
  1. 1Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
  2. 2Ophthalmology and Visual Sciences Academic Clinical Program, Duke-National University of Singapore Medical School, Singapore
  3. 3SERI-NTU Advanced Ocular Engineering (STANCE), Singapore
  4. 4Institute for Health Technologies, Nanyang Technological University, Singapore
  5. 5Department of Clinical Pharmacology, Medical University Vienna, Vienna, Austria
  6. 6Center for Medical Physics and Biomedical Engineering, Medical University Vienna, Vienna, Austria
  7. 7Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
  1. Correspondence to Dr Ning Cheung, Singapore Eye Research Institute, Singapore 169856, Singapore; cheung.ning{at}


Background/aims To examine the relationship between macular perfusion, as assessed using optical coherence tomography angiography (OCTA), and long-term visual outcome after surgical repair of macula-off rhegmatogenous retinal detachment (RRD).

Methods A prospective study of 29 patients who had undergone successful surgical repair of macula-off RRD. OCTA imaging was performed at month 3 and repeated at months 6 and 12 after surgery. Associations between OCTA parameters including, foveal avascular zone (FAZ) area, vessel density (VD) in the superficial capillary plexus (SCP) and deep capillary plexus (DCP), choriocapillaris flow deficit features and logMAR best-corrected visual acuity (VA) were assessed using a random intercept hybrid linear mixed model.

Results Over the 1-year follow-up, VA improved (0.025 logMAR/ month, 95% CI 0.015 to 0.035) and FAZ area decreased (−0.020 mm2/month, 95% CI −0.032 to −0.007). Better VA after surgery was significantly associated with denser superficial VD (β=0.079, 95% CI 0.026 to 0.131), lower number of choriocapillaris flow deficits (β=−0.087, 95% CI −0.154 to −0.021) and larger average size of choriocapillaris flow deficits (β=0.085, 95% CI 0.022 to 0.147), after adjusting for baseline VA, types of surgery and other factors.

Conclusions OCTA measures of vascular perfusion in the macula may provide new pathophysiological insights and prognostic information related to macula-off RRD.

  • retina
  • macula
  • imaging
  • treatment surgery

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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  • Contributors JC, NC and LS had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design was undertaken by NC, JC and LS. Statistical analysis was performed by AG and JC. NC and LS obtained funding. Study supervision was undertaken by NC and LS.

  • Funding This research is supported by the Singapore Ministry of Health’s National Medical Research Council under its Transition Award (NMRC/TA/0054/2016), Centre Grant Programme (NMRC/CG/C010A/2017_SERI), Open-Fund Large Collaborative Grant: OF-LCG (NMRC/OFLCG/004c/2018), Transition Award (MOH-000249), Duke-NUS Khoo Pilot Awards (Duke-NUS-KMRA(TA)/2015/0004; Duke-NUS-KP(Coll)/2018/0009A) and SERI-Lee Foundation Pilot Grant (R1687/10/2020 (LF1019-1)).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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