<p>Optical coherence tomography angiography features in patients with idiopathic full-thickness macular hole, before and after surgical treatment</p>

Abstract

PurposeTo present optical coherence tomography (OCT) angiography features in patients with idiopathic full-thickness macular hole before and after vitrectomy.Study designProspective case series study.Materials and methodsPatients presenting with an idiopathic full-thickness macular hole (IMH) who underwent posterior vitrectomy with internal limiting membrane peeling and gas tamponade were included in the study. En face OCT and OCT angiography (OCTA) was performed pre- and postoperatively using 3×3 mm scans (Optovue, XR Avanti). Foveal avascular zone (FAZ) area, macular hole size (MHS), central retinal thickness (CRT), macular parafoveal choriocapillary flow area (MCFA), and fovea vessel density (FVDS) were measured and assessed using OCTA. Best-corrected visual acuity (BCVA) was examined before and 3 months after surgery.ResultsTwenty-eight eyes of 28 patients were included in the study. The mean age of patient group was 68.28 years. The hole was closed in all eyes after the initial surgery. OCTA showed enlargement of FAZ and increased CRT in foveal area. Mean preoperative FAZ area was 0.39±0.07 mm2. En face images of the middle retina showed a range of preoperative cystic patterns surrounding the hole. BCVA was improved from 0.1±0.11 preoperatively to 0.42±0.17 postoperatively. Mean FAZ area was reduced to 0.24±0.07 mm2 postoperatively with resolution of macular hole and adjacent cystic areas. Mean CRT was reduced from 396±62.6 µm pre-operatively to 272±30.7 µm postoperatively. After vitrectomy, the parafoveal choriocapillary flow area and FVDS of IMH eyes increased compared with the preoperative measurements.ConclusionQuantitative evaluation of vascular and morphological changes following IMH surgery using OCTA shows the potential for recovery due to vascular and neuronal plasticity. OCTA showing vascular changes and their quantitative characteristics might be a useful tool for the assessment of macular holes before and after surgical treatment.

Secondary Vitrectomy with Internal Limiting Membrane Plug due to Persistent Full-Thickness Macular Hole OCT-Angiography and Microperimetry Features: Case Series

“…Mean FVDS in SCP was 29.84% ± 4.17% preoperatively and increased to 35.02% ± 3.47% postoperatively. They found a relatively strong correlation between preoperative FAZ and postoperative BCVA [ 24 ]. In our patients, the best results in OCTA images presented Case 2 with the lowest FAZ and the highest FVDS.…”

“…Previous studies have reported characteristics of OCTA images in eyes with FTMH or comparison of OCTA images before and after surgery [ 22 – 24 ]. Analysis of OCTA images in eyes after secondary vitrectomy due to FTMH should be performed in a bigger sample of patients and compared with the group of patients with successful first surgery.…”

Morpho-Functional Evaluation of Full-Thickness Macular Holes by the Integration of Optical Coherence Tomography Angiography and Microperimetry

“…OCTA is a novel imaging technique that utilizes motion contrast to visualize retinal microvasculature in a rapid, noninvasive way. To date, several studies have reported vascular changes and quantitative characteristics of OCTA images in eyes with MH, considering this new technique to be a useful tool for the assessment of MHs before and after surgical treatment [24].…”

Optical coherence tomography angiography using the black-and-white pixel binarization histogram software: a new technique for evaluating healing of macular holes in two surgical techniques

“…The postoperative findings were increased foveal vascular density in the superficial plexus, increased flow area in the choriocapillaris, and a reduced foveal avascular zone. These anatomic and hemodynamic changes implied that the recovery process of the inner retina has neuronal and vascular plasticity [20].…”