Authors
Doktorova T.A.1, Boiko E.V.1, 2, Suetov A.A.1, 3, Sosnovskiy S.V.1
1 St. Petersburg Branch S. Fyodorov Eye Microsurgery Federal State Institution St. Petersburg
2 Department of Ophthalmology Mechnikov North-West State Medical University St. Petersburg
3 State Scientific Research Test Institute of Military Medicine, St. Petersburg
Abstract
Rationale: The effect of retinal perfusion on functional recovery of the fovea, as well as the value of quantitative perfusion parameters as predictors of functional outcome in the surgical treatment of full-thickness macular holes (FTMH) remains poorly understood.
Objective: To study the relationship between changes in retinal perfusion and functional parameters of the fovea in the postoperative period at 1 and 2 types of FTMH closure.
Methods: A prospective study including 93 patients (93 eyes) with idiopathic FTMH stage 2-4 according to D. Gass after surgical treatment. In subgroups with type 1 and type 2 of FTMH closure, changes in the foveal avascular zone (FAZ) area and vessel density in the superficial and deep capillary plexuses (SCP and DCP) in the fovea, changes in BCVA, retinal sensitivity (RS) at the fixation point, and P1 amplitude in the fovea were studied. Studies were performed preoperatively, 1 and 6 months after surgery. A significant correlation was found between the changes in BCVA, RS at the fixation point, P1 amplitude in the fovea, and changes in vessel density in the SCP and DCP, which was more pronounced in the period from 1 to 6 months after surgery. The correlation of the changes in the parameters is higher in type 2 of FTMH closure than in type 1 of FTMH closure.
Results:. Subgroups with type 1 and type 2 FTMH closure included 67 and 26 eyes, respectively. Type 2 FTMH closure showed lower vascular density in the DCP before (p=0.02) and 6 months after surgery (p=0.03), lower BCVA before surgery (p=0.03), 1 and 6 months after surgery (p<0.001), lower RS at the fixation point before and after surgery (p<0.007) and P1 amplitude after surgery (p<0.002).
Conclusion. In type 2 macular hole closure, postoperative changes in retinal perfusion have a more pronounced impact on functional recovery of the fovea, especially in the late postoperative period.
Keywords: full-thickness macular hole, optical coherence tomography-angiography, perfusion, foveal avascular zone, retina.
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