| Objective:Optical coherence tomography angiography(OCTA)and micro visual field were used to observe the relationship between postoperative macular microvascular morphology and visual function in patients with idiopathic macular hole(IMH).Methods:This retrospective clinical study included 28 eyes from 28 patients diagnosed with idiopathic macular hole who were admitted to The Affiliated eye hospital of Nanchang University Hospital from June 2021 to October 2021.The changes of macular microvascular morphology in IMH patients were studied by measuring the area of foveal avascular zone area(FAZ),retinal vessel densities of the superficial capillary plexus(VSCP)and retinal perfusion densities of the superficial capillary plexus(PSCP).The relationship between the changes of microvascular morphology and the changes of visual function in IMH patients were studied by examining the changes of mean sensitivity(MS),focal stability(FS)and their relationship with the lesion area.All patients were examined preoperatively,one week postoperatively,one month postoperatively and three months postoperatively with Zeiss Cirrus HD-OCT 5000 optical coherence tomogram-phy and the third generation microperimetry-3(MP-3),best corrected visual acuity(BCVA),macular hole diameter,FAZ,VSCP,PSCP,MS,and FS were examined.Results:1.A total of 28 persons were included in the analysis,with an average age of68.82±7.17 years,13(46.4%)males and 15(53.6%)females respectively.The average diameter of macular hole was 645.46±131.54 mm,including 20 cases of stage Ⅲ hole and 8 cases of stage Ⅳ hole,All the macular holes were closed postoperatively without secondary glaucoma,retinal detachment or macular edema.2.BCVA(Log MAR)increased from 1.000(0.635-1.475)to 0.750(0.500-0.975)in 3 months after surgery(P<0.001).3.Changes of retinal microcirculation in macular region: the foveal avascular zone area(FAZ)decreased significantly at 1 week after operation,and increased gradually from 1 month to 3 months after operation,but was still smaller than that before operation,the difference was statistically significant(p<0.05).The retinal perfusion densities of the superficial capillary plexus(PSCP)in the central subregion,the superior and the nasal side of the inner ring increased 3 months after the operation(p<0.05),PSCP increased at 3 months postoperatively compared with 1 week postoperatively(p<0.05),and superficial retinal capillary length density(VSCP)increased at 3 months postoperatively compared with preoperatively,there was significant difference(p<0.05).PSCP increased at 3 months after operation compared with 1 week(p<0.05).4.Visual function: the mean sensitivity(MS)of 3 months after operation was significantly higher than that of 1 week before and after operation(p<0.05).The visual acuity of 1 month after operation was significantly higher than that of 1 week after operation,there was significant difference(p<0.05),and the focal stability(FS)of the patients increased 1 week,1 month and 3 months after operation,there were significant differences(p<0.05)5.The correlation between microcirculation and visual function: there was a negative correlation between MS and aperture and FAZ area at 3 months postoperativ-ely.The larger the preoperative pore size and the FAZ area 3 months after operation,the worse the prognosis of visual function.There was a positive correlation between MS and PSCP and VSCP in central sub-region 3 months after operation.The bigger PSCP and VSCP in central sub-region was,the better the prognosis of visual function was.Conclusion:1.In IMH patients,the macular fovea blood flow improved,FAZ area decreased,PSCP increased in the central subarea,the superior and nasal side of the inner ring,and VSCP increased in the central subarea.2.In the aspect of macular visual function,the MS of IMH patients increased and the FS was improved.3.The changes of MS in MH patients were negatively correlated with FAZ area and pore size,but positively correlated with PSCP and VSCP in central sub-region. |
