Suprachoroidal Space in Rhegmatogenous Retinal Detachment Assessed with Optical Coherence Tomography: Implications for Potential Future Therapeutic Interventions

Purpose: To comprehensively investigate the suprachoroidal space (SCS) in the context of rhegmatogenous retinal detachment (RRD) using swept-source optical coherence tomography (SS-OCT). Methods: We conducted a post hoc analysis of 90 consecutive patients with a primary RRD. Baseline SS-OCT scans were graded for the presence and thickness of the suprachoroidal space. Available scans of the fellow eye were graded for comparison. Results: The suprachoroidal space was visible in 31.6% (24/76) of gradable RRD scans, with a mean thickest location measuring 67.0µm (SD 25.9), mean thinnest location of 33.8µm (SD 11.1), and mean average thickness of 50.0µm (SD 16.8). Additionally, the SCS was detectable in 28.3% (13/46) of available fellow eye scans, with a mean thickest location measuring 47.0µm (SD 41.7), thinnest location of 25.2µm (SD 27.6) and mean average thickness of 35.8µm (SD 31.4). A statistically significant difference was found between RRD and fellow eyes in all measurements of SCS thickness. Conclusion: In RRD, the suprachoroidal space serves as a crucial fluid reservoir influenced by dynamic shifts in intraocular hydrostatic and oncotic pressures. We found significant SCS engorgement in RRD eyes compared to fellow eyes, which may facilitate intra-SCS therapies such as suprachoroidal viscopexy (SCVEXY) or other pharmacologic interventions.