Determination of Quantitative Macular Perfusion Assessment in Surgical and Non-surgical Cases of Early-stage Myopic Traction Maculopathy

Abstract

The present study aimed to compare quantitative changes in macular perfusion in normal eyes, healthy highly myopic eyes, eyes with myopic foveoschisis (MF)/foveoretinal detachment (FRD) not treated surgically, and eyes with early stages of macular traction maculopathy (MTM) and fully resolved myopic FRD treated surgically. This retrospective, consecutive, comparative, interventional, single-surgeon, case-control study was carried out on 118 eyes (104 individuals) between October 2015 and April 2021. Subjects included normal emmetropic eyes (control emmetropia, n = 25); healthy myopic eyes (control high myopia, n = 20); eyes with MF/FRD not treated surgically (non-surgical observational group, n = 28); and structurally fully resolved myopic eyes with FRD treated surgically (surgically treated group, n = 45). Spectral-domain optical coherence tomography (SD-OCT) and OCT angiography were used to assess long-term postoperative structural, functional, and perfusional outcomes. According to the findings, In the surgical group, the mean evolution time of myopic FRD was 6.2 ± 3.6 months. The mean follow-up time was 25.9 ± 10.3 months. The mean time for the myopic FRD resolution was 4.6 ± 1.9 weeks. In the FRD surgical group, median best-corrected visual acuity increased from 0.90 logarithm of the minimum angle of resolution (logMAR; 0.60–1.00) to 0.30 logMAR (0.09–1.00), a highly significant improvement (p < 0.0001). The groups' quantitative vascular density (VD) evaluation results were considerably different (p < 0.001). The superficial foveal avascular zone (FAZ) area was significantly greater in the non-surgical group (p < 0.0001). Lower SD-OCT structural postoperative findings and higher VD quantification values were strongly connected with better final visual acuity results (p < 0.05). The observational group had a considerably higher central subfoveal thickness while the surgical group had a significantly lower central subfoveal thickness (both p<0.05).). Our findings revealed that the surgical group had a higher rate of postoperative microstructural abnormalities on SD-OCT (91.4%) than the non-surgical group, as well as a high rate of statistically significant VD quantitative deficiencies and FAZ abnormalities, and marked improvement in VD and FAZ in the fully surgically resolved myopic FRD group (p < 0.05).