Changes in choroidal blood flow in patients with macular hole after surgery

A macular hole (MH) is a defect that occurs in the retina and involves all layers. In this study, we aimed to investigate the preoperative and postoperative choriocapillaris blood flow (CBF) changes in patients with MH and the role of CBF in the pathogenesis of the disease using optical coherence tomography angiography (OCTA).

This is a retrospective study examining eyes with MH. The study included 25 operated eyes of 25 patients and contralateral eyes of 18 patients. CBF and subfoveal choroidal thickness were examined using the OCTA images of the patients before surgery and at the first, third and sixth months after surgery.

The mean CBF value of the patients was 1.57±0.20 mm² preoperatively, 1.94±0.13 mm² at the postoperative first month, 1.98±0.12 mm² at the third month, and 2.00±0.10 mm² at the sixth month. The increases in the CBF values between the preoperative period and the postoperative measurements were statistically significant (p<0.0001 for all). In the preoperative period, the CBF value of the contralateral eyes was 2.07±0.10 mm². The preoperative CBF value of the contralateral eyes was higher compared to that of the eyes with MH (p<0.0001). There was no significant difference between the preoperative CBF value of the contralateral eyes and the postoperative sixth-month value of the eyes with MH (p = 0.065).

The preoperative and postoperative third-month CBF values of the eyes with MH were found to be lower than those of the contralateral eyes, but there was no difference between the postoperative sixth-month CBF value of the eyes with MH and the preoperative CBF value of the contralateral eyes. We consider that the eyes with MH achieve similar CBF values to the contralateral eyes in an average of six months after successful surgery.