The Formation Of Perifoveal Cysts In Idiopathic Macular Hole And Its Relationship With Retinal Blood Flow

Objective:To study the formation and distribution of the perifoveal cysts in idiopathic macular hole(IMH)and its correlation with retinal blood flow.Method:In the second hospital of Hebei medical university,39 eyes of 37 IMH patients diagnosed by FFA and OCT(including 2 patients with binocular diseases)were included in this study.There were total 16 cases with hole diameter less than 400?m(small hole group)and 23 cases with hole diameter larger than 400?m(large hole group).In preoperative procedure,we adopted en face OCT to measure the cystic cavity number,the total area and the average size of the cystic cavity in the inner nuclear layer,outer plexiform and Henle fiber layer complex around the hole,and used Optical coherence tomography angiography(OCTA)to measure the vascular density of the retinal superficial capillary plexuses and deep capillary plexuses of all cases.OCTA was used postoperatively to measure the vascular density of the superficial and deep capillary plexuses in 17 eyes.We conducted correlation statistical analysis on the data and drew a conclusion.Results:Preoperative number of the cystic cavities(94±86)and the total area(0.856±0.541mm~2)in the inner layer of the large hole group was greater than the number of the cystic cavities(29±31)and the total area(0.337±0.333mm~2)in the inner layer of the small hole group(t=-2.882,P=0.007,t=-3.412 P=0.002).Preoperative number of the cystic cavities(33±14)and the total area(1.466±0.689 mm~2)in the outer plexiform and Henle fiber layer complex of the large hole group was greater than the number of the cystic cavities(17±11)and the total area(0.856±0.541 mm~2)in the inner layer of the small hole group(t=-3.935 P=0.000,t=-4.335 P=0.000).The average cystic area of the inner layer and outer plexiform and Henle fiber layer complex were(0.014±0.016mm2)and(0.056±0.042mm2)in the large hole group,and(0.015±0.027mm2)and(0.035±0.026mm2)in the small hole group respectively,with no statistical difference(t=0.178 P=0.860,t=-1.767 P=0.085)There was a significant correlation among the macular hole diameter,the number of cysts and the total area of cysts in the outer plexiform and Henle fiber layer complex,the vascular density of the retinal superficial capillary plexuses and deep capillary plexuses,the respectively coefficients were-0.725,-0.474,-0.314,-0.768,+0.624.The result indicated the diameter of macular hole was positively correlated with the number and total area of cysts of outer plexiform layer and Henle fiber layer complex,preoperative vascular density of the retinal superficial capillary plexuses was positively correlated with the number and total area of cysts of outer plexiform layer and Henle fiber layer complex,preoperative vascular density of the retinal deep capillary plexuses was negatively correlated with the number and total area of cysts of outer plexiform layer and Henle fiber layer complex.There was no statistical difference between the preoperative and postoperative about the vascular density of the retinal superficial capillary plexuses and deep capillary plexuses(t=-2.007 P=0.062,t=-1.003 P=0.331).And there was no correlation between the number of cysts and the total area of cysts in the preoperative inner layer and outer plexiform and Henle fiber layer complex and the postoperative vascular density of superficial and deep capillary plexuses(P>0.05).Conclusions:1.The diameter of the idiopathic macular hole was related to the formation of cysts around the hole;2.The formation of cysts around the holes of idiopathic macular hole affected the vascular density of the superficial and deep capillaries plexuses of the retina;3.The diameter of idiopathic macular hole had no direct effect on the retinal capillary vascular density,but affected the retinal vascular density indirectly by affecting the formation of intraretinal cysts around the hole;4.There was no statistically significant difference between the superficial and deep capillary vascular densities preoperatively and postoperatively;5.The preoperative cavity around the hole was not related to the vascular density of the superficial and deep retinal capillaries postoperative.