Assessment of Macular Microvasculature Before and After Idiopathic Macular Hole Surgery by Optical coherence tomography angiography

Abstract

Purpose : To evaluate the macular microvasculature before and after surgery for idiopathic macular hole (MH) and the association of preoperative vascular parameters with postoperative recovery of visual acuity and configuration.

Methods : Optical coherence tomography angiography (OCTA) was used to obtain en face images before and 1 and 3 months after the vitrectomy with ILM peeling for 16 eyes of 16 patients with an idiopathic macular hole. Preoperative foveal avascular zone (FAZ) area and perimeter and regional vessel density (VD) in both layers were compared according to the 3-month best-corrected visual acuity (BCVA). Association between macular microvasculature and 3-month BCVA was analyzed.

Results : The preoperative deep VD was smaller and the FAZ perimeter was larger in the 3-month BCVA ＜0.6 group. A significant reduction was observed in FAZ parameters and all VDs 2 weeks postoperatively. Except for deep perifoveal VD, all VDs recovered only to their preoperative values. The postoperative FAZ parameters were lower during follow-up. Decreases in preoperative deep VDs were correlated with worse postoperative VA. A larger FAZ perimeter and a lower deep perifoveal VD preoperatively were associated with lower healing stage.

Conclusions : The status of the deep vasculature may be an indicator of VA in patients with a closed MH. Except for the deep perifoveal region, VD recovered only to preoperative levels.

This is a 2020 ARVO Annual Meeting abstract.

 

Figure 1. Macular region analyzed for vessel density (VD) calculation.

 

Figure 2. Representative OCTA images for one eye with idiopathic macular hole before and 1 and 3 months after surgery