What question did this study set out to answer?

The aim is to evaluate retinal and choriocapillaris changes after vitrectomy in eyes with macula-off retinal detachment.

March 29, 2026Open Access

Optical coherence tomography angiography evaluation of retinal and choriocapillaris changes after pars plana vitrectomy for macula-off rhegmatogenous retinal detachment: perfluoropropane versus silicone oil tamponade

Key Points

The aim is to evaluate retinal and choriocapillaris changes after vitrectomy in eyes with macula-off retinal detachment.
Prospective cohort study design
Included 30 eyes with macula-off retinal detachment and 30 healthy fellow eyes
Used optical coherence tomography angiography to measure vascular layers and choriocapillaris flow
Analyzed data at multiple time points: 2, 3, 5, and 6 months postoperatively
Compared two types of intravitreal tamponade: perfluoropropane gas and silicone oil
Silicone oil group showed significantly reduced parafoveal capillary plexus density and macular thickness compared to controls
Choriocapillaris flow was lower in the silicone oil group at 5 and 6 months
C3F8 group showed temporary reductions in deep capillary plexus density but recovered over time
FAZ area showed no significant difference between groups
A strong negative correlation exists between changes in capillary plexus density and best-corrected visual acuity in the silicone oil group

Abstract

Rhegmatogenous retinal detachment (RRD) with macular involvement may lead to persistent visual impairment despite successful anatomical repair. Different intravitreal tamponade agents used during pars plana vitrectomy (PPV) may variably affect retinal and choroidal microcirculation. This study aimed to evaluate longitudinal changes in retinal vascular layers and choriocapillaris flow (CCF) using optical coherence tomography angiography (OCT-A) in macula-off RRD eyes treated with perfluoropropane (C3F8) gas or silicone oil (SO) tamponade. In this prospective cohort study, 30 eyes of 30 patients with macula-off RRD who underwent PPV using either C3F8 gas (n = 13) or 1000-cSt SO (n = 17) were included, along with 30 healthy fellow eyes as controls. OCT-A measurements were obtained at 2, 3, 5, and 6 months postoperatively. Foveal and parafoveal superficial capillary plexus (SCPVD), deep capillary plexus (DCPVD) vessel density, foveal avascular zone (FAZ), CCF, and macular thickness were analyzed and compared longitudinally and with healthy fellow eyes. Parafoveal SCPVD and macular thickness were significantly reduced in the SO group compared with controls at all time points (p < 0.05). CCF measurements in both 1-mm and 2-mm radius areas were significantly lower in the SO group at 5 and 6 months, even after SO removal (p < 0.05). In contrast, the C3F8 group showed transient reductions in DCPVD at 2 and 3 months, with subsequent recovery. FAZ area did not differ significantly between groups. Correlation analysis revealed a strong negative correlation between changes in SCPVD and changes in BCVA in the SO group. SO tamponade is associated with persistent impairment of macular microcirculation and CCF that does not fully recover after oil removal, whereas retinal vascular changes following C3F8 tamponade appear largely reversible. OCT-A may be a valuable noninvasive tool for guiding tamponade selection and determining optimal timing of SO removal in macula-off RRD surgery.

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