Shahlaee Abtin, Rahimy Ehsan, Hsu Jason, Gupta Omesh P, Ho Allen C
Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, PA, USA.
Palo Alto Medical Foundation, San Francisco, CA, USA.
Am J Ophthalmol Case Rep. 2016 Oct 29;5:20-25. doi: 10.1016/j.ajoc.2016.10.008. eCollection 2017 Apr.
To characterize and quantify the pre- and postoperative foveal structural and functional patterns in full-thickness macular holes.
Subjects presenting with a full-thickness macular hole that had pre- and postoperative imaging were included. En face optical coherence tomography (OCT) and OCT angiography (OCTA) was performed. Foveal avascular zone (FAZ) area, macular hole size, number and size of perifoveal cysts were measured.
Five eyes from 5 patients were included in the study. The hole was closed in all eyes after the initial surgery. OCTA showed enlargement of the FAZ and delineation of the holes within the FAZ. Mean preoperative FAZ area was 0.41 ± 0.104 mm. Visual acuity was improved and mean FAZ area was reduced to 0.27 ± 0.098 mm postoperatively ( < 0.05) with resolution of the macular hole and adjacent cystic areas. En face images of the middle retina showed a range of preoperative cystic patterns surrounding the hole. Smaller holes showed fewer but larger cystic areas and larger holes had more numerous but smaller cystic areas.
Quantitative evaluation of vascular and cystic changes following macular hole repair demonstrates the potential for recovery due to neuronal and vascular plasticity. Perifoveal microstructural patterns and their quantitative characteristics may serve as useful anatomic biomarkers for assessment of macular holes.
对全层黄斑裂孔术前和术后的黄斑中心凹结构及功能模式进行特征描述和量化分析。
纳入有术前和术后影像学资料的全层黄斑裂孔患者。进行了正面光学相干断层扫描（OCT）和OCT血管造影（OCTA）。测量黄斑中心凹无血管区（FAZ）面积、黄斑裂孔大小、黄斑中心凹周围囊肿的数量和大小。
研究纳入了5例患者的5只眼。初次手术后所有眼的裂孔均闭合。OCTA显示FAZ扩大，且FAZ内裂孔清晰可见。术前平均FAZ面积为0.41±0.104平方毫米。术后视力改善，随着黄斑裂孔及相邻囊性区域的消退，平均FAZ面积降至0.27±0.098平方毫米（P<0.05）。视网膜中层的正面图像显示术前裂孔周围有一系列囊性模式。较小的裂孔显示较少但较大的囊性区域，而较大的裂孔有较多但较小的囊性区域。
黄斑裂孔修复术后血管和囊性变化的定量评估表明，由于神经元和血管可塑性，存在恢复的潜力。黄斑中心凹周围的微观结构模式及其定量特征可能作为评估黄斑裂孔的有用解剖生物标志物。
