TY - JOUR T1 - Assessment of Retinal Perfusion Using Wide Field Swept Source OCTA in Diabetic TRD: Pre and Postoperative Correlation Study AU - Tony, Mathew AU - Sangeeth, S. AU - Gopal, Biju AU - Sangeethaa, M. AU - Anjanikumar, Sodesetti AU - Niranjanaprabha, J. JO - Research Journal of Medical Sciences VL - 18 IS - 11 SP - 625 EP - 629 PY - 2024 DA - 2001/08/19 SN - 1815-9346 DO - makrjms.2024.11.625.629 UR - https://makhillpublications.co/view-article.php?doi=makrjms.2024.11.625.629 KW - Swept‐source OCT angiography KW - diabetic tractional retinal detachment KW - retinal perfusion KW - pars plana vitrectomy KW - foveal a vascular zone KW - vessel density KW - wide field OCTA KW - proliferative diabetic retinopathy AB -

Tractional retinal detachment (TRD) is a severe vision‐threatening complication of proliferative diabetic retinopathy (PDR). Surgical intervention using pars plana vitrectomy (PPV) aims to restore anatomical integrity and preserve or improve vision. Recent advances in wide field swept‐source optical coherence tomography angiography (WF SS‐OCTA) enable non‐invasive, high‐resolution visualization of retinal perfusion and microvascular changes before and after surgery. To evaluate quantitative and qualitative changes in retinal perfusion using WF SS‐OCTA in eyes with diabetic TRD before and after surgical repair and to correlate these findings with clinical and anatomical outcomes. A prospective observational study was conducted at the Bascom Palmer Eye Institute, University of Miami, between January 2018 and December 2019. A total of 31 eyes from 21 patients with TRD due to PDR were imaged using a WF SS‐OCTA system (PLEX Elite 9000). Eyes underwent PPV with membrane peeling and laser photo coagulation. OCTA images were obtained preoperatively and at 1 and 4 months postoperatively. Key parameters analyzed included foveal a vascular zone (FAZ) area, vessel length density (VLD) and perfusion density (PD) in superficial and deep capillary plexuses. Successful image acquisition was achieved in 26 of 31 eyes (83.9%) at baseline and in 28 of 31 eyes (90.3%) at 4 months. Postoperative OCTA revealed a significant increase in VLD and PD in both superficial and deep vascular layers (p<0.05). FAZ area remained stable postoperatively. Eyes with resolved traction showed improved macular perfusion, while areas previously affected by fibrovascular membranes remained ischemic. No significant correlation was observed between perfusion metrics and visual acuity recovery. WF SS‐OCTA provides valuable insight into microvascular remodeling after surgical repair of diabetic TRD. Although retinal perfusion improves in areas relieved from traction, persistent ischemia in chronically damaged zones limits functional recovery. WF SS‐OCTA is a promising tool for longitudinal monitoring of diabetic retinal disease and surgical outcomes.

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