Zou Jingling, Wang Nan, Zhang Feng, Lian Haiyan, Zeng Jun, Yang Yan
Beijing Tongren Eye Center Research Ward, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Tongren Hospital, Beijing Institute of Ophthalmology, Capital Medical University, Beijing, China.
Department of Ophthalmology, Peking University First Hospital, Miyun Campus, Beijing, China.
Photodiagnosis Photodyn Ther. 2025 Oct;55:104767. doi: 10.1016/j.pdpdt.2025.104767. Epub 2025 Aug 21.
To investigate the features of the macular microcirculation using optical coherence tomography angiography (OCTA) in surgically closed idiopathic full-thickness macular hole (IFTMH) and the correlated independent prognostic factors for postoperative macular microcirculation remodeling.
Twenty-seven eyes of 27 patients after successful IFTMH surgery that were followed for 6 months and 27 eyes of 27 age- and gender-matched healthy subjects were included. Patients with IFTMH and healthy subjects were examined using OCTA. Macular vessel density (VD), foveal avascular zone (FAZ) area of superficial capillary plexus (SCP), and flow area of outer retina and choroid were analyzed. Best-corrected visual acuity (BCVA) was evaluated before and 6 months after the surgery.
The BCVA improved in eyes with IFTMH after the surgery (p < 0.001). Postoperative VD was significantly lower in eyes with IFHMH compared with the normal control eyes (p < 0.001). The mean flow area of the outer retina in eyes that underwent IFTMH surgery was significantly larger than normal control eyes (p < 0.05), while the mean flow area of choroid capillary in postoperative IFTMH was significantly lower (p < 0.01). Foveal VD was negatively correlated with both minimal and basal diameters (r = -0.473, p < 0.05; r = -0.504, p < 0.01). FAZ area was significantly positively correlated with both minimal and basal diameters (r = 0.635, p < 0.001; r = 0.606, p < 0.01). Additionally, the age of IFTMH was negatively correlated with the postoperative whole VD (r = -0.440, p < 0.05) and positively correlated with the FAZ area (r = 0.382, p < 0.05).
Macular capillary plexuses observed by OCTA in eyes after IFTMH surgery had different characteristics compared to normal control eyes. Preoperative IFTMH characteristics can serve as prognostic factors for postoperative macular microcirculation remodeling.
利用光学相干断层扫描血管造影（OCTA）研究手术封闭的特发性全层黄斑裂孔（IFTMH）的黄斑微循环特征以及术后黄斑微循环重塑的相关独立预后因素。
纳入27例成功进行IFTMH手术且随访6个月的患者的27只眼，以及27例年龄和性别匹配的健康受试者的27只眼。对IFTMH患者和健康受试者进行OCTA检查。分析黄斑血管密度（VD）、浅表毛细血管丛（SCP）的中心凹无血管区（FAZ）面积以及外视网膜和脉络膜的血流面积。在手术前和手术后6个月评估最佳矫正视力（BCVA）。
IFTMH患者术后BCVA有所改善（p < 0.001）。与正常对照眼相比，IFHMH患者术后VD显著降低（p < 0.001）。接受IFTMH手术的眼的外视网膜平均血流面积显著大于正常对照眼（p < 0.05），而术后IFTMH的脉络膜毛细血管平均血流面积显著降低（p < 0.01）。中心凹VD与最小直径和基底直径均呈负相关（r = -0.473，p < 0.05；r = -0.504，p < 0.01）。FAZ面积与最小直径和基底直径均呈显著正相关（r = 0.635，p < 0.001；r = 0.606，p < 0.01）。此外，IFTMH的年龄与术后全层VD呈负相关（r = -0.440，p < 0.05），与FAZ面积呈正相关（r = 0.382，p < 0.05）。
与正常对照眼相比，OCTA观察到的IFTMH手术后眼的黄斑毛细血管丛具有不同特征。术前IFTMH特征可作为术后黄斑微循环重塑的预后因素。
