| Purpose:To study the changes of macular blood flow and ganglion cell complex(GCC)thickness in patients with rhegmatogenous retinal detachment(RRD)after silicone oil tamponade and the factors that correlated with the changes of macular blood flow and GCC thickness,and to explore the correlation between the changes of macular blood flow and GCC thickness.Method:From March 2021 to May 2022,34 patients(34 eyes)who met the inclusion criteria and were diagnosed as monocular RRD were selected from the Second Hospital of Jilin University.The operation was performed by the same experienced ophthalmologist.The main operation method was pars plana vitrectomy、retinal detachment repair and vitreous silicone oil tamponade.After the operation,regular review showed that the retina was well reset,and secondary surgery was performed to remove the silicone oil in time.The affected eyes were taken as the observation group,and the contralateral healthy eyes were taken as the control group.OCTA in both eyes before silicone oil removal,OCTA in the affected eyes 1 month and 3 months after silicone oil removal,and observe the SCP blood flow density and DCP blood flow density of the whole 3mm×3mm regions,fovea and parafovea areas;FAZ areas and perimeters;GCC average thickness,FLV,GLV.All data were statistically analyzed by SPSS25.0 software.The comparison between the observation group and the control group before silicone oil removal,1 month and 3 months after silicone oil removal was performed by independent sample t-test,and the comparison between the observation group and the control group at different time points was performed by repeated measurement analysis of variance,and the comparison between the two groups was performed by Bonferroni method.Pearson correlation analysis was used to study the correlation between the difference of macular blood flow parameters,the difference of GCC parameters and various factors between the affected and healthy eyes three months after silicone oil removal,and the correlation between the difference of blood flow density and the difference of GCC average thickness before and three months after silicone oil removal.P<0.05 indicates that the difference is statistically significant.Result:1.SCP blood flow density:(1)Comparison between the observation group and the control group at each time point(before silicone oil removal,1 month and 3 months after silicone oil removal): Compared with the healthy eyes,the overall 3mm×3mm macula area of the affected eyes was smaller before and 1 month after silicone oil removal(P =0.001;P=0.006);The measurements in the foveal area decreased before and 1 month after silicone oil removal(P =0.003;P =0.019);The measurements in the para-foveal area decreased before silicone oil removal(P =0.017);There was no significant difference in SCP blood flow density between the affected eye and the healthy eye at 3 months after silicone oil removal in the whole area,3 months after silicone oil removal in the fovea area,1 and 3months after silicone oil removal in the parafovea area(P > 0.05).(2)Comparison of different time points in the observation group(before silicone oil removal,1 month and 3 months after silicone oil removal): There were significant changes at different time points in the whole region(P =0.008);The pairwise comparison showed that 3 months after silicone oil removal was higher than before silicone oil removal(P <0.001),and 1 month after silicone oil removal was not statistically significant compared with before silicone oil removal(P > 0.05).The foveal area showed significant changes at different time points(P=0.004).The pairwise comparison showed that 3 months after silicone oil removal increased compared with before silicone oil removal(P =0.006),but 1month after silicone oil removal showed no statistical significance compared with before silicone oil removal(P > 0.05).There was no statistical significance in the changes of the para-fovea area at different time points(P > 0.05).2.DCP blood flow density:(1)Comparison between the observation group and the control group at each time point(before silicone oil removal,1 month and 3 months after silicone oil removal): Compared with the healthy eyes,the overall area of the affected eyes decreased before silicone oil removal,1 month and 3 months after silicone oil removal(P <0.001;P < 0.001;P =0.016);The measurements in the foveal area decreased before and 1month after silicone oil removal(P =0.008;P =0.011);The measurements in the para-foveal area decreased before,1 month and 3 months after silicone oil removal(P < 0.001;P < 0.001;P < 0.001);There was no significant difference in DCP blood flow density of the fovea area between affected eyes and healthy eyes at 3 months after silicone oil removal(P > 0.05).(2)Comparison of different time points in the observation group(before silicone oil removal,1 month and 3 months after silicone oil removal): There were significant changes at different time points in the whole region(P < 0.001);The pairwise comparison showed that 3 months after silicone oil removal was higher than that before silicone oil removal(P=0.002),and 1 month after silicone oil removal was not statistically significant compared with that before silicone oil removal(P > 0.05).There was no statistical significance in the fovea area and para-fovea area at different time points(P > 0.05).3.FAZ area and perimeter:(1)Comparison between the observation group and the control group at each time point(before silicone oil removal,1 month and 3 months after silicone oil removal): Compared with the healthy eye,FAZ area of the observation group was increased before silicone oil removal and 1 month after silicone oil removal(P < 0.001;P =0.014).FAZ perimeter increased before silicone oil removal and 1 month after silicone oil removal(P < 0.001;P < 0.001).There was no significant difference in FAZ area and perimeter between the two groups at 3 months after silicone oil removal(P > 0.05).(2)Comparison of different time points in the observation group(before silicone oil removal,1 month and 3 months after silicone oil removal): There were significant changes in FAZ area at different time points(P < 0.001);The results of pairwise comparison showed that compared with those before silicone oil removal,the values decreased at 1 month and 3months after silicone oil removal(P < 0.001;P < 0.001).There were significant changes in FAZ perimeter at different time points(P < 0.001).The results of pairwise comparison showed that compared with those before silicone oil removal,the values decreased at 1month and 3 months after silicone oil removal(P < 0.001;P < 0.001).4.Average GCC thickness,FLV,GLV:(1)Comparison between the observation group and the control group at each time point(before silicone oil removal,1 month and 3 months after silicone oil removal): The average GCC thickness of the observation group was decreased before silicone oil removal(P < 0.001),and there was no significant difference between the observation group and the control group at 1 month and 3 months after silicone oil removal;FLV increased before silicone oil removal,decreased at 1 month after silicone oil removal,and increased at 3 months after silicone oil removal(P < 0.001;P =0.003;P=0.006).GLV was increased before silicone oil removal(P < 0.001),and there was no significant difference between the two groups at 1 month and 3 months after silicone oil removal(P > 0.05).(2)Comparison of different time points in the observation group(before silicone oil removal,1 month and 3 months after silicone oil removal): The average thickness of GCC changed significantly at different time points(P < 0.001).The results of pairwise comparison showed that compared with those before silicone oil removal,the average thickness of GCC increased at 1 month and 3 months after silicone oil removal(P < 0.001;P < 0.001),and decreased at 3 months after silicone oil removal compared with 1 month after silicone oil removal(P < 0.001).There were significant changes in FLV at different time points(P <0.001).The results of pairwise comparison showed that compared with those before silicone oil removal,the values decreased at 1 month and 3 months after silicone oil removal(P <0.001;P < 0.001).Compared with 1 month after silicone oil removal,3 months after silicone oil removal increased,but there was no statistical significance(P > 0.05).GLV changed significantly at different time points(P < 0.001).The results of pairwise comparison showed that compared with those before silicone oil removal,the values decreased at 1 month and 3months after silicone oil removal(P < 0.001;P < 0.001).Compared with 1 month after silicone oil removal,the measurement of 3 months after silicone oil removal increased,but there was no statistical significance(P > 0.05).5.Correlation analysis:(1)SCP blood flow density: The difference of SCP blood flow density in the whole region was positively correlated with the involvement of retinal detachment in the macular area and the time of silicone oil tamponade.(r =0.372,P =0.030;r =0.522,P =0.002).There was no significant correlation between the difference of SCP blood flow density in the foveal region and any factor(P > 0.05).The difference of SCP blood flow density in the para-foveal region was positively correlated with the time of silicone oil tamponade.(r =0.435,P =0.010).(2)DCP blood flow density: The difference of DCP blood flow density in the whole region was positively correlated with the time of silicone oil tamponade.(r =0.374,P=0.029).The difference of DCP blood flow density in the fovea region was positively correlated with the involvement of retinal detachment in the macular area(r =0.679,P <0.001).The difference of DCP blood flow density in the parafoveal region was positively correlated with the involvement of retinal detachment in the macular area and the time of silicone oil tamponade.(r =0.540,P =0.001;r =0.355,P =0.039).(3)FAZ: The difference of area and perimeter had no significant correlation with any factor(P > 0.05).(4)GCC: The average thickness difference of GCC was positively correlated with the time of silicone oil tamponade.(r=0.404,P =0.018).The difference of FLV was positively correlated with the time of silicone oil tamponade.(r =0.647,P < 0.001).There was no significant correlation between the difference of GLV and any factor(P > 0.05).6.Correlation analysis of the difference of macular blood flow density and GCC thickness showed that the difference of SCP blood flow density before silicone oil removal was positively correlated with the difference of GCC average thickness(r =0.413,P =0.015).There was no significant correlation between the difference of DCP blood flow density and the difference of GCC average thickness(P > 0.05).There was no significant correlation between the difference of SCP blood flow density,DCP blood flow density and the difference of GCC average thickness at 3 months after silicone oil removal(P > 0.05).Conclusions:1.Compared with the contralateral healthy eyes,SCP blood flow density and DCP blood flow density in the whole macular area,fovea and parafovea of the affected eyes decreased significantly during silicone oil tamponade,while FAZ area and perimeter increased significantly.The average thickness of GCC decreased significantly,while FLV and GLV increased significantly.2.After silicone oil removal,SCP blood flow density and DCP blood flow density of the whole macular area and foveal area,and DCP blood flow density of the whole macular area and foveal area increased with time,while FAZ area and perimeter decreased.DCP blood flow density of the whole macular area and parafoveal area was still lower than that of the healthy eyes at 3 months after silicone oil removal.After silicone oil removal,the average thickness of GCC increased,FLV and GLV decreased,and FLV was still larger than that of healthy eyes at 3 months after silicone oil removal.3.The time of silicone oil tamponade and the involvement of retinal detachment in the macular area were correlated with the changes of macular blood flow density after silicone oil tamponade;There was a correlation between the change of GCC thickness after silicone oil tamponade and the time of silicone oil tamponade.4.There was a positive correlation between the change of SCP blood flow density and the change of GCC thickness in the macular area during silicone oil tamponade. |
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