Analysis of the choroidal vascularity by optical coherence tomography angiography for prediction of postoperative anatomical outcomes in idiopathic macular holes

Abstract

Purpose : To evaluate the choroidal vascular density (CVD) of idiopathic macular hole (IMH) and determine its relationship with postoperative anatomical outcome in IMH.

Methods : 20 patients (20 eyes) with stage III or IV IMH who underwent pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling were enrolled in the study. Optical coherence tomography (OCT) and angiography (OCTA) was performed before and after PPV. Preoperative vascular density of each layer was measured with binarized en-face OCTA images. Modified CVD (mCVD) was defined as ratio of CVD to outer retina vascular density (ORVD) to compensate technical bias. Postoperative anatomical outcome (AO) of IMH was defined as ratio of least foveal thickness (LFT) to maximum parafovea thickness (MPT) from OCT. A regression analysis was performed on preoperative parameters with AO.

Results : There were significantly positive correlations between CVD and AO (R² = 0.387, β = 0.622, P = 0.003). mCVD produced more reliable and explainable results (R² = 0.605, β = 0.778, P < 0.001). Other potential parameters showed no significant correlation with AO.

Conclusions : Choroidal blood flow contributes to ultimate structural healing of IMH after PPV.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.