Macular microvasculature differences in patients with macular hole after vitrectomy with internal limiting membrane removal or single-layered temporal inverted flap technique.

Abstract

To compare the macular microvasculature differences in cases with idiopathic macular hole (MH) after vitrectomy when using internal limiting membrane (ILM) removal or temporal inverted ILM flap technique (IFT). A total of 34 patients were included, of whom 20 were treated vitrectomy with ILM removal (group 1), and 14 were treated with IFT (group 2). The OCTA (RTVue; Optovue, Fremont, CA) parameters, including foveal avascular zone (FAZ), vessel density (VD) ratios in superficial capillary plexus (SCP), and deep capillary plexus (DCP) were evaluated at baseline and 6 months follow-up. The VD measurements in DCP and inner retinal thickness (IRT) in temporal and nasal sectors were compared in subanalyses. There was no significant difference in means of post-operative BCVA and FAZ between the two groups (p = 0.943, p = 0.760). The mean VDs of the DCP was significantly decreased at 6 months postoperatively in both groups (p < 0.001, p < 0.001). The mean post-operative temporal VDs of DCP were similar in the two groups, but the mean post-operative nasal VDs of the DCP was lower in group 1 than in group 2 (p = 0.005 and p = 0.03 for parafovea and perifovea, respectively). The mean temporal IRTs were similar in the two groups, but paranasal and perinasal IRTs were significantly thinner in group 1 than in group 2 (p < 0.001, p < 0.001). The mean post-operative VDs of parafoveal and perifoveal temporal and nasal quadrants in DCP significantly and positively correlated with the IRTs. Single-layered temporal IFT causes fewer VD changes when compared to complete ILM removal, especially in the DCP.