Evaluation of OCTA-based Parameters in Full-thickness Macular Holes: A Prospective, Comparative, Interventional Study

This study aims to correlate optical coherence tomography angiography (OCTA)-based retinal microvasculature changes in cases of full-thickness macular hole (FTMH) before and after vitreoretinal surgery and its relation to patient's visual recovery.

Data of 31 eyes with FTMH were evaluated preoperatively and post-operatively at 6, 12, and 24 weeks for OCTA parameters and compared.

93.55% eyes (29 eyes) showed improvement in best-corrected visual acuity at 24 weeks. The mean foveal avascular zone (FAZ) significantly reduced from 0.41 ± 0.13 mm² (preoperatively) to 0.25 ± 0.01 mm² (postoperatively at 24 weeks). Mean preoperative vessel density (VD) in the superficial vascular plexus (SVP) progressively improved to 24.2% ± 2.2%, 25.2% ± 2.1% and 25.8% ± 2.3% at 6, 12, and 24 weeks respectively from 24.4% ± 2.1% preoperatively (P = 0.0, F = 5.1). The mean VD of foveal region in the SVP significantly improved (P < 0.0, F = 13.9) while that of the parafoveal region did not improve at 24 weeks (P = 0.3, F = 1.2) when compared with its preoperative status. The mean preoperative VD in the deep vascular plexus (DVP) was 20.2% ± 2.6%. It significantly improved at 6, 12, and 24 weeks (20.3% ± 2.4%, 21.8% ± 2.3% and 22.1% ± 2.2%, respectively; P = 0.0, F = 6.9). The mean VD of foveal region and parafoveal region in the DVP showed significant improvement when compared with its preoperative status (P < 0.0, F = 39.3, P < 0.0, F = 13.7).

This study showed reduction in mean FAZ area and improvement in mean VD at SVP and DVP in the macula postoperatively. Routine perioperative OCTA-based documentation of macular vascularity in FTMH may throw a light in cases with anatomico-functional postoperative disparities in future.