| Objective: To explore the effect of the area of cystoid cavities and macular retinal sensitivity and perfusion density in idiopathic macular hole(IMH).Methods:This was a retrospective study,collecting 25 eyes of 25 patients who were diagnosed with idiopathic macular hole in the Second Hospital of Hebei Medical University from 2020.7 to 2021.2.The control group was the contralateral healthy eye.Before operation,SD-OCT was used to measure the diameter of macular hole,the length of IS/OS defect and the height of macular hole edge in all patients.Perfusion density of superficial capillary plexuses(SCP),deep capillary plexuses(DCP)and choriocapillaris(CC)were obtained by OCTA.The area of cystoid cavities was assessed on the slab corresponding to the DCP in en-face OCT using the Image J software.The central macular sensitivity(CMS)and mean macular sensitivity(MMS)were measured by microperimetry-3(MP-3).The microperimetry images were superimposed on slabs corresponding to DCP in OCTA,and the average retinal sensitivity in the range of the capsule was identified and calculated which compared with the control group.One month after operation,the same equipments and methods were used to measure the perfusion density of retinal and choroidal capillaries,CMS and MMS in 12 eyes filled with aseptic air in vitreous cavity.We conducted correlation statistical analysis on the data and drew a conclusion.Results:By superimposing the microperimetry image with the DCP layer of OCTA,it was found that the retinal sensitivity corresponding to the macular hole decreases obviously,showing an absolute scotoma,and the visual acuity in the area of the low reflection signal capsule around it decreases,showing a relative scotoma ring.The average retinal sensitivity in the cystic cavity(4.24±3.07 d B)was significantly lower than that in the control group(19.08±6.11 d B)(P<0.05,the difference was statistically significant).The area of cystoid cavities was positively correlated with the diameter and height of the macular hole and the length of IS/OS defect(P<0.05).The cyst area was positively correlated with preoperative BCVA(r=0.57,P<0.05),and negatively correlated with preoperative CMS and MMS(r=-0.53,P=0.01;r=-0.47,P=0.02).Through the scatter plot,we found that the larger diameter macular hole associated with the larger cyst area and the lower preoperative visual acuity and lower retinal sensitivity.The area of cystoid cavities was negatively correlated with the perfusion density of the DCP and the CC before operation(P<0.05).The preoperative CMS and MMS were positively correlated with the perfusion density of CC layer(P<0.05).There was a negative correlation between preoperative cyst area and postoperative CMS and MMS(r=-0.65,P=0.02;r=-0.62,P=0.03).However,we did not find any relationship between cyst area and postoperative BCVA,postoperative retinal and choroidal capillary perfusion density(P>0.05).Conclusion:1.The cystic cavity structure around the IMH will affect the visual function,resulting in the decrease of retinal sensitivity.2.The area of the cystic cavity around the IMH was significantly related to the diameter of the hole,the height of the macular hole and the length of the IS/OS defect.3.The formation of the cystic cavity damages the retinal structure and affects the retinal and choroidal perfusion density,but for postoperative perfusion density it has no effect in a short time.4.The cyst area is related to the postoperative retinal sensitivity,and the cyst area may be used as a prognostic index of postoperative visual acuity.5.The combination of OCTA and Microperimetry can analyze the relationship between morphological and functional changes of IMH,which helps us to further understand the disease. |
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