Purpose

To quantify short-term microvascular changes after pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling in patients with idiopathic macular hole (IMH) using optical coherence tomography angiography (OCTA).

Design

Cohort Study.

Participants

This study included patients with IMH. Affected eyes were compared with fellow eyes.

Methods

6 × 6 mm OCTA (Zeiss Angioplex, Zeiss Meditec, Dublin, CA, USA) images of the study eye and fellow eye were acquired one day before surgery, 4 weeks and 12 weeks after surgery. Microvascular alterations in the superficial and deep capillary plexus were assessed by measuring vessel density and the shortest distance to the surrounding vessels of all intercapillary pixels. Only vessels enclosed by an ETDRS Grid centered on the fovea were analyzed.

Main outcome measures

Change of vessel density and vessel distance to baseline.

Results

OCTA images of the 15 study and 15 fellow eyes of 15 included patients (mean ± SD of age: 67.89 ± 5.2 years) were analyzed and revealed a significant increase in vessel density and decrease in vessel distance of the deep capillary plexus in study eyes 4 weeks after surgery compared to baseline. Our superficial capillary plexus findings were the inverse, namely a significant decrease in vessel density and increase in vessel distance. Postoperative microvascular changes proved to be closely associated with the extent of retinal thickness reduction in the perifoveal deep capillary plexus.

Conclusions

IMH closure after PPV and ILM peeling caused a significantly improved microvasculature in the deep capillary plexus, which may represent reorganized perifoveal microvasculature due to the regression of cystoid spaces.

中文翻译：

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通过光学相干断层扫描血管造影评估黄斑裂孔闭合后黄斑凹周围微血管的重组。

目的

为了量化特发性黄斑裂孔（IMH）患者使用光学相干断层扫描血管造影术（OCTA）进行的平板内玻璃体切除术（PPV）和内部限制膜（ILM）剥皮后的短期微血管变化。

设计

队列研究。

参加者

该研究包括IMH患者。将受影响的眼睛与其他眼睛进行比较。

方法

在手术前一天，手术后4周和12周获取研究眼和另一只眼的6×6 mm OCTA（Zeiss Angioplex，Zeiss Meditec，美国加利福尼亚州）图像。通过测量血管密度和所有毛细血管间像素与周围血管的最短距离，可以评估浅表和深层毛细血管丛中的微血管改变。仅分析了以中央凹为中心的ETDRS网格包围的血管。

主要观察指标

血管密度和血管距离基线的变化。

结果

分析了15例研究的OCTA图像和15例患者的15眼的同伴眼睛（平均±SD年龄：67.89±5.2岁），发现研究眼睛的血管密度显着增加，深层毛细血管丛的血管距离缩短4术后几周与基线相比。我们的表层毛细血管丛发现是相反的，即血管密度显着降低和血管距离增加。术后微血管改变被证实与小凹周围深毛细血管丛的视网膜厚度减少程度密切相关。

结论

PPV和ILM剥离后IMH闭合导致深层毛细血管丛中的微血管明显改善，由于囊状间隙的消退，这可能代表了重组的中央凹微血管。