| Objective: Study on changes of retinal and choroidal blood circulation in patients with idiopathic macular hole(IMH)before and after surgery and its role in the occurrence of IMH.Method:30 patients with clinically confirmed monocular IMH(case group)were included in this study.The IMH eyes and unaffected fellow eyes were set up to group A and B respectively,all of which were 30 eyes.30 normal persons and 30 eyes were selected as the healthy control group(group C).According to the hole diameter in group A patients were divided into 2 subgroups: D:hole diameter less than or equal to 500μm;E: hole diameter of >500μm.OCT angiography was used to measure the macular foveal avascular zone(FAZ),the superficial and deep retinal capillary blood flow area and blood flow density in the case group and healthy control group,the blood flow area and blood flow density in the superficial choroidal layer.Finally,the statistical analysis was performed.Results: The FAZ in the eyes of IMH before operation was higher than that in the unaffected fellow eyes,and all of the two were larger than those in the healthy control group(P<0.05).There was no significant difference in the flow area and vessel density of the superficial retinal capillary in the IMH eyes,unaffected fellow eyes and the healthy control group before operation(P>0.05).There was no significant difference in the flow area of the deep retinal capillary in the IMH eyes,unaffected fellow eyes and the healthy control group before operation(P>0.05).Vessel density of the deep retinal capillary in the macular area was significantly lower in IMH eyes than unaffected fellow eyes and healthy control eyes before surgery(P<0.05).The mean flow area and vessel density in the macular area of choriocapillary was significantly smallerand lower in IMH eyes than unaffected fellow eyes and healthy control eyes(P<0.05),while no difference was found between unaffected fellow eyes and the healthy control eyes(P>0.05).The FAZ in group D was less than that in group E(P<0.05).In group D,the superficial and deep retinal blood flow area and blood flow density in the macular area were higher than that of the E group(P<0.05).The superficial choroidal blood flow area and blood flow density in group D were higher than that in group E(P<0.05).The macular hole diameter was positively correlated with FAZ(r=0.566 P=0.001),was negatively correlated with flow area and vessel density of the deep retinal capillary(r=-0.669 P=0.000,r=-0.636 P=0.000)and was negatively correlated with flow area and vessel density of the choriocapillaris(r=-0.377 P=0.044,r=-0.477 P=0.009).There was no significant difference between the superficial retinal capillary blood flow area,vessel density and deep blood flow area in the retina of the macular area of IMH after operation(P>0.05).The superficial foveal avascular zone was significantly decreased in IMH eyes than preoperative.The vessel density of the deep retinal capillary was significantly higher after surgery(P<0.05).The area of the choroidal capillary flow area and vessel density in the macular area of the IMH patients eyes were significantly higher after vitrectomy(P<0.05).Conclusions:1.Macular retinal circulation has no significant effect on macular hole.2.The diameter of the macular hole was proportional to the FAZ,and was inversely proportional to the deep retinal and superficial capillary blood flow area and blood flow density in the macular region.3.Macular hole can undergo centripetal movement after the operation.The larger FAZ in contralateral healthy eyes may have certain predictive value for the occurrence of macular hole.4.There is a certain correlation between the changes of FAZ,choroidal capillary circulation and macular region microstructures in the macular region.The changes in the tissue structure of the macular region may lead to a reversible changes in the choroidal capillary circulation in the macular region. |
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