Choroidal Vascularity and Visual Outcomes in Macula-Off Rhegmatogenous Retinal Detachment

Abstract Purpose: To investigate the association between visual outcomes and choroidal changes in patients with macula-off rhegmatogenous retinal detachment (RRD). Methods: This study reviewed retrospectively 63 eyes with macula-off RRD who underwent vitrectomy. Their fellow eyes were analyzed as a control group. The choroidal vascularity index (CVI), ellipsoid zone/external limiting membrane integrity, central foveal thickness (CFT), and subfoveal choroidal thickness were documented and analyzed. Linear regression analyses were performed to identify factors affecting the final best-corrected visual acuity (BCVA). Results: Eyes with RRD showed increased CVI (68.8±4.1) compared to the control group (66.1±8.8, p=0.028). Multivariate linear regression analysis revealed that patients with a poor final BCVA had a longer detachment duration (p=0.002), worse baseline BCVA (p=0.034), thinner CFT (p=0.005), and greater CVI (p=0.001) and were more likely to be tamponated with silicone oil (p=0.001). CVI was particularly increased in eyes with poor ellipsoid zone/external limiting membrane integrity, prolonged detachment duration, thin CFT, and worse BCVA. Conclusion: Increased CVI could indicate poor visual outcomes in macula-off RRD patients. Choroidal remodeling could be associated with the disruption of the ellipsoid zone/external limiting membrane integrity.