Department of Ophthalmology, Aichi Medical University, Nagakute, Japan.
Transl Vis Sci Technol. 2020 Jul 14;9(8):20. doi: 10.1167/tvst.9.8.20. eCollection 2020 Jul.
To evaluate changes in the foveal avascular zone (FAZ) area during the postoperative period of macular hole (MH) surgery using the optical coherence tomography angiography (OCTA) and to investigate its relationship to visual acuity (VA).
Consecutive unilateral MH patients who underwent successful MH closure with at least a six-month observation period were studied retrospectively. To evaluate the FAZ area, OCTA images were obtained at the preoperative visit, the first postoperative visit, and the six-month visit. Main outcome measures were postoperative FAZ change and its relationship to VA change after MH closure.
Fifty-one cases were studied. The FAZ area was 0.42 ± 0.11 mm at the preoperative visit, 0.25 ± 0.091 mm at the first postoperative visit and 0.31 ± 0.11 mm at the six-month visit. FAZ area at the first postoperative visit was significantly smaller ( < 0.0001) than at the preoperative visit. FAZ area at the six-month visit was significantly greater ( < 0.0001) than at the first postoperative visit, but still significantly smaller ( = 0.0002) compared to the normal fellow eye. The postoperative FAZ area enlargement from the first postoperative visit to the six-month visit was significantly correlated with the postoperative VA recovery ( = 0.0322) and the postoperative photoreceptor reconstruction ( = 0.0213).
The FAZ area once decreases along with MH closure; it thereafter increases toward the normal value over time. The postoperative FAZ change was correlated with the VA recovery.
This study suggests that the postoperative FAZ area enlargement might be a potential biomarker indicating foveal reconstruction after MH closure.
利用光相干断层扫描血管造影（OCTA）评估黄斑裂孔（MH）手术后黄斑中心凹无血管区（FAZ）面积的变化，并探讨其与视力（VA）的关系。
回顾性分析了 51 例连续单侧 MH 患者，这些患者均成功接受 MH 闭合手术，且至少有 6 个月的观察期。为了评估 FAZ 面积，在术前、术后第 1 天和术后 6 个月分别进行 OCTA 图像采集。主要观察指标为 MH 闭合术后 FAZ 的变化及其与术后 VA 变化的关系。
51 例患者纳入研究。术前 FAZ 面积为 0.42±0.11mm，术后第 1 天为 0.25±0.091mm，术后 6 个月为 0.31±0.11mm。术后第 1 天 FAZ 面积明显小于术前（ < 0.0001）。术后 6 个月 FAZ 面积明显大于术后第 1 天（ < 0.0001），但仍明显小于正常对侧眼（ = 0.0002）。术后第 1 天至术后 6 个月 FAZ 面积增大与术后 VA 恢复（ = 0.0322）和术后光感受器重建（ = 0.0213）呈显著相关。
随着 MH 闭合，FAZ 面积首先减小，随后随着时间的推移向正常范围增大。术后 FAZ 的变化与 VA 的恢复相关。
本研究提示术后 FAZ 面积增大可能是 MH 闭合后黄斑中心凹重建的潜在生物标志物。
