| Objective: To observe the changes of choroidal capillary blood flow in macular area and analysis of related risk factors in patients with idiopathic macular hole(IMH)before and after surgery.Methods: Clinical data of 19 monocular IMH patients(case group)who were diagnosed and surgically treated in Zhejiang Provincial People’s Hospital from August2019 to March 2021 were selected,and the affected eye and contralateral eye in the case group were defined as group A and group B,respectively.Nineteen healthy people(19eyes)with matched age and gender were selected as normal control group C.All patients underwent visual acuity,OCT,OCTA,blood viscosity and other examinations.Group A(case group)received PPV combined with internal boundary membrane stripping and overturning tamping and intravitreous C3F8 filling.OCT was used to examine the closure of macular hole in group A after operation.The CBFA and CBFD of choroidal capillary blood flow area(CBFA)and blood flow density(CBFD)in macular area of group A,B and C and the changes of CBFA and CBFD in macular area of group A at 1 month and 3 months after surgery were measured by OCTA.The above data were collected for relevant statistical analysis.Results: There was no significant difference in age and sex composition between the case group and the normal control group(P<0.05).Before operation,the CBFA of group A,B and C were(2.57±0.42),(3.19±0.49)and(3.41±0.23),and the CBFD of group A,B and C were(0.19±0.04),(0.34±0.08)and(0.37±0.05),respectively.The overall difference was statistically significant,CBFA(F=24.187,P<0.001),CBFD(F=49.367,P<0.001),a further pairwise comparison.Further pairwise comparison was performed between group A and group B,the difference was statistically significant,CBFA(P<0.001),CBFD(P<0.001);Further pairwise comparison was performed between group A and group C,the difference was statistically significant,CBFA(P<0.001),CBFD(P<0.001);Further pairwise comparison was performed between group B and group C,and there was no statistically significant difference in CBFA(P=0.092)and CBFD(P=0.055).The hiatus was closed in all the 19 patients.The CBFA was(2.86±0.42)and(3.09±0.45)at 1 month and 3 months post-operation,respectively.The CBFD was(0.24±0.04)and(0.29±0.04)at 1 month and 3 months post-operation,respectively.The total differences were statistically significant,CBFA(F=8.392,P=0.001)and CBFD(F=27.548,P<0.001).Further pairwise comparison showed that there was no statistically significant difference in CBFA between preoperative and postoperative 1 month(P=0.090),while there was statistically significant difference in CBFD between preoperative and postoperative 1 month(P=0.002).The difference in CBFA between preoperative and postoperative 3 months was statistically significant(P<0.001),and there was statistical significance in CBFD(P<0.001).There was no statistically significant difference in CBFA between 1 month and 3 months post-operation(P=0.197),while there was statistically significant difference in CBFD between 1 month and 3 months post-operation(P=0.001).Case group and control group were compared,high tangent relative index(t=4.719,P<0.001),high cut(t=4.296,P<0.001)and middle cut(t=1.550,P=0.001),the difference was statistically significant.Conclusion: Macular area choroid blood perfusion in the suffering eye of monocular IMH patients was significantly lower than the contralateral and healthy eye,but no significant difference between the contralateral and healthy eye.The choroid blood capillary blood flow area and density of the macular area have different degrees of improvement after surgery.Partial blood viscosity index in patients with idiopathic macular hole is significantly higher than that in healthy people. |
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