Functional restoration of the fovea after surgery of full-thickness macular hole: data from a multimodal topographically based approach

Purpose. To evaluate the relationship between changes in functional and structural indicators, indicators of retinal perfusion in the fovea after surgery of full-thickness macular holes (FTMH). Material and methods. A prospective study was conducted on 62 patients (62 eyes) with FTMH stages 1–4 who underwent surgical treatment. We studied BCVA, retinal sensitivity (RS) at fixation point (FP), the fixation zone area, the amplitude and implicit time of P1 at FP, the thickness of the macular complex of ganglion cells (mcGC), the ellipsoid zone (EZ) defect area, the foveal avascular zone (FAZ) area and vessel density in the superficial and deep capillary plexuses (SCP and DCP). The correlation of indicator changes in the period from the preoperative examination to 6 months after treatment and in the period from 1 to 6 months after treatment was studied. Results. Changes in BCVA in the period from the preoperative examination to 6 months after surgery significantly correlated with changes in mcGC thickness (R=0.39, p=0.004), EZ defect area (R= –029, p=0.001) and SCP and DCP vessel density (R=0.35 and R=0.29, p=0.002); RS changes at FP correlated with the changes in EZ defect area (R= –0.31, p=0.001), and P1 amplitude with the change in the EZ defect area (R= –0.34, p=0.001) and vessel density in DCP (R= –0.29, p=0.001). In the period from 1 to 6 months after closure of the FTMH, a more significant correlation of changes in BCVA, RS and P1 amplitude of mentioned above indicators was observed. Conclusion. Processes of functional restoration of the fovea after surgery of FTMH for at least 6 months is influenced by changes in such indicators as the mcGC thickness, the EZ defect area, and vessel density of SCP and DCP. In the late postoperative period, the importance of postoperative changes in retinal perfusion increases. Key words: Full-thickness macular hole (FTMH), microperimetry, multifocal electroretinography, multimodal imaging, optical coherence tomography, optical coherence tomography-angiography