Abstract
Rhegmatogenous retinal detachment (RRD) associated with giant retinal
tears (GRTs) can cause significant visual impairment due to structural or perfusional
macular sequelae. This condition is an acute-onset incident that leads to a full-thickness
circumferential retinal tear of at least 90°. Limited data are available concerning the
patients´ long-term perfusional status after successful surgery for GRTs with maculaoff RRD. This chapter examines the long-term outcomes of eyes treated with varying
degrees of GRT-associated RRD extensions and compares them with those of two
control groups. The surgical group was subdivided according to GRT-associated RRD
extension as follows: eyes with extension of <180° and eyes with extension > of >180°.
The eyes were further classified according to whether complementary 360° scleral
buckle (SB) placement was required. Postoperative optical coherence tomography
(OCT) demonstrated that 33.3% of the eyes had abnormal foveal contours, 39.4% had
ellipsoid zone (EZ) disruption, 2 had dissociated optic nerve fiber layer (DONFL)
defects, and 45.4% had external limiting membrane (ELM) line discontinuities. OCT
angiography (OCT-A) revealed abnormal perfusion indices in surgically treated eyes
(p<0.0001). Postsurgical best-corrected visual acuity (BCVA) was negatively
correlated with the superficial foveal avascular zone area, superficial parafoveal vessel density, and central subfoveal thickness but positively correlated with the
choriocapillaris flow area (CFA). Moreover, eyes treated surgically for GRT-associated
RRD had multiple structural alterations reflected by spectral-domain OCT biomarkers
and OCT-A perfusional findings correlated with visual outcomes. Despite successful
retinal reattachment without proliferation, management of GRT-associated RRD
remains challenging.