Macular perfusion analysis using optical coherence tomography angiography post rhegmatogenous retinal detachment repair: A systematic review and meta-analysis

Authors

• Abdullah Ahmed, Department of Ophthalmology and Visual Sciences, University of Illinois Chicago, Chicago, IL, USA.
• Fiza Shaheen, Department of Ophthalmology, Shifa International Hospital, Islamabad, Pakistan.
• Hashem Abu Serhan, Department of Ophthalmology, Hamad Medical Corporation, Al-Rayyan St., 3050, Doha, Qatar. [email protected].
• Zain Ali Nadeem, Department of Medicine, Allama Iqbal Medical College, Lahore, Pakistan.
• Mahrukh Chaudhry, Department of Medicine, Allama Iqbal Medical College, Lahore, Pakistan.
• Eeman Ahmad, Department of Medicine, Fatima Memorial Hospital College of Medicine and Dentistry, Lahore, Pakistan.
• Hasan Khan, Department of Ophthalmology and Visual Sciences, University of Illinois Chicago, Chicago, IL, USA.
• Shahzaib Ahmed, Department of Medicine, Fatima Memorial Hospital College of Medicine and Dentistry, Lahore, Pakistan.
• Umar Akram, Department of Medicine, Allama Iqbal Medical College, Lahore, Pakistan.
• Muhammad Talha, Shaikh Khalifa Bin Zayed Al-Nahyan Medical and Dental College, Lahore, Pakistan.
• Obaid Ur Rehman, Department of Medicine, Services Institute of Medical Sciences, Lahore, Pakistan.
• Ayman G. Elnahry, Advocate Health - Midwest
• Muhammad Amer Awan, Department of Ophthalmology, Shifa International Hospital, Islamabad, Pakistan.

Recommended Citation

Ahmed A, Shaheen F, Abu Serhan H, et al. Macular perfusion analysis using optical coherence tomography angiography post rhegmatogenous retinal detachment repair: a systematic review and meta-analysis. Int Ophthalmol. 2026;46(1):336. Published 2026 Aug 20. doi:10.1007/s10792-026-04210-8

Affiliations

Aurora BayCare Medical Center, Green Bay

Abstract

Background: Evaluating rhegmatogenous retinal detachment (RRD) repair traditionally focuses on anatomical reattachment and visual acuity. Understanding macular perfusion changes post-repair offers a more comprehensive assessment. Optical coherence tomography angiography (OCTA) non-invasively visualizes retinal microvasculature, enabling detailed perfusion analysis.

Methods: Our protocol was registered (PROSPERO CRD42024533072). We searched PubMed, Scopus, ScienceDirect, and Cochrane databases (from inception to November 2024) for studies comparing OCTA parameters between post-repair RRD eyes and controls. Analyzed parameters included foveal avascular zone (FAZ) area, foveal (FVD) and parafoveal vascular density (PFVD), choriocapillaris (CC) perfusion, and best-corrected visual acuity (BCVA). Data were analyzed for macula-ON and macula-OFF groups using a random-effects model.

Results: Twenty studies comprising 686 RRD eyes (231 macula-ON, 455 macula-OFF) and 686 control eyes were analyzed. In macula-OFF cases, FAZ area remained significantly enlarged post-repair in both superficial capillary plexus (SCP) (0.06 mm², 95% CI: 0.02-0.09) and deep capillary plexus (DCP) (0.12 mm², 95% CI: 0.04-0.19). FVD showed no significant differences in either group. PFVD demonstrated a significant reduction in DCP for both macula-ON (- 1.38%, 95% CI: - 2.72 to - 0.05) and macula-OFF (- 2.83%, 95% CI: - 5.04 to - 0.63) groups. CC perfusion density showed a significant reduction post-repair (- 2.39%, 95% CI: - 4.56 to - 0.22). Postoperative BCVA improved significantly in macula-OFF cases (0.79 logMAR, 95% CI: 0.37-1.21) but showed no significant change in macula-ON cases.

Conclusions: Despite successful anatomical repair of RRD, persistent alterations in macular perfusion parameters were observed, particularly in the macula-OFF group. The enlarged FAZ area and reduced PFVD and CC perfusion density suggest lasting changes in the retinal microvasculature post-repair. However, significant improvement in BCVA, especially in macula-OFF cases, indicates that functional recovery may occur despite these vascular changes. These findings highlight the need for comprehensive assessment beyond isolated perfusion metrics when evaluating surgical success in RRD repair.

Document Type

Article

PubMed ID

42622880