Diagnostic value of microflow imaging in secondary retinal detachment

Background Traditional fundus examination and optical coherence tomography are limited in diagnosing secondary retinal detachment in cases of vitreous hemorrhage, opaque refractive media, and other conditions. Ultrasonography is non-invasive, convenient, and unaffected by refractive media, making it an important clinical screening tool. Microflow imaging (MFI) can visualize low-velocity and microvascular flow, but its diagnostic value in secondary retinal detachment requires further validation. Methods This was a retrospective case study. A total of 95 patients (110 eyes) with secondary retinal detachment treated at Affiliated Zhongshan Hospital of Dalian University from December 2023 to December 2024 were enrolled and divided into three groups: tractional retinal detachment, complete retinal detachment, and partial retinal detachment. All eyes underwent B-mode ultrasonography, color Doppler flow imaging (CDFI), and MFI. Using surgical findings as the reference standard, receiver operating characteristic (ROC) curves were constructed to compare the sensitivity, specificity, and area under the curve (AUC) of CDFI and MFI. Results Among the 95 patients, 55 (57.9%) were male and 40 (42.1%) were female. For tractional retinal detachment (40 eyes, 36.3%): the AUC of CDFI was 0.838, with a sensitivity of 67.5% and specificity of 100%; the AUC of MFI was 0.916, with a sensitivity of 87.5% and specificity of 95.7%. For complete retinal detachment (38 eyes, 34.5%): the AUC of CDFI was 0.947, with a sensitivity of 89.5% and specificity of 100%; the AUC of MFI was 0.974, with a sensitivity of 94.7% and specificity of 100%. For partial retinal detachment (32 eyes, 29.0%): the AUC of CDFI was 0.875, with a sensitivity of 75.0% and specificity of 100%; the AUC of MFI was 0.940, with a sensitivity of 90.6% and specificity of 97.4%. MFI showed significantly higher sensitivity than CDFI in all types of secondary retinal detachment. Conclusion B- mode ultrasonography combined with CDFI allows effective diagnosis of secondary retinal detachment. MFI significantly improves the detection rate of low-velocity microvascular flow and yields higher diagnostic sensitivity. The combined use of B-mode ultrasonography, CDFI, and MFI provides a non-invasive, convenient, and efficient imaging diagnostic protocol suitable for clinical application.