Optical coherence tomography angiography features in patients with idiopathic macular holes before and after vitrectomy

Abstract

Purpose Optical coherence tomography angiography (OCTA) is a novel noninvasive imaging tool for retinal and optic nerve head (ONH) perfusion. The study aimed to explore OCTA features in patients with idiopathic macular holes (IMHs) before and after vitrectomy. Methods The retrospective case series study included patients with IMHs diagnosed by OCT between June 2019 and June 2021 in our hospital. The best corrected visual acuity (BCVA), superficial and deep foveal avascular zone (FAZ) area, blood flow density within 300µm width of FAZ (FD300) and the state of external limiting membrane (ELM) were examined by OCTA. Results Totally 26 patients (9 men and 17 women) aged 65.08 ± 5.09 years were included, with an average disease course of 154.15 ± 206.26 days. Visual acuity showed no improvement at 1 month but was improved at 6 months (P < 0.05). FAZ, superficial FAZ, deep FAZ, and FD300 showed a decreasing tendency at 1 month, indicating an amelioration following surgery. Though data within 6 months showed decreased efficacy over time, there were significant improvements compared with preoperative parameters (P < 0.05). The 1-month FAZ in the deep layer (P < 0.01) and FD300 (P < 0.01) were significantly increased in the ELM (+) group. The differences were more pronounced at 6 months (FAZ in the deep layer: P < 0.01; FD300: P < 0.01). Conclusion OCTA may dynamically monitor the neurovascular repair process of IMH and predict the prognosis of visual function after IMH operation.