The effect of changes in retinal perfusion on postoperative recovery of foveal function in full-thickness macular holes

BACKGROUND: Data on the effect of changes in retinal perfusion on retinal functional recovery at surgical treatment of full-thickness macular holes are limited. AIM: To investigate the effect of changes in retinal perfusion on postoperative recovery of fovea function in full-thickness macular holes. MATERIALS AND METHODS: A prospective study included data of 93 patients (93 eyes) with full-thickness macular holes. Optical coherence tomography-angiography (OCT-A), visual acuity testing, microperimetry, and multifocal electroretinography were performed before surgical treatment, after 1 and 6 months. We studied the relationship between changes in foveal avascular zone area, vessel density in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) with changes in best corrected visual acuity (BCVA), retinal sensitivity (RS) at the fixation point and P1 amplitude in the fovea at different periods after treatment. RESULTS: After surgical hole closure, a significant decrease in foveal avascular zone area, increase in vascular density in SCP and DCP was found within 1 month after treatment (p 0.001). Significant increase in BCVA, RS and P1 amplitude was observed 1 and 6 months after hole closure (p 0.001). The most pronounced correlation was found in the long-term postoperative period between the change in vessel density in the SCP and the change in BCVA, RS and P1 amplitude (r = 0.42, r = 0.26 and r = 0.3, p 0.05), as well as between the change in vessel density in the DCP and the change in BCVA, RS and P1 amplitude (r = 0.41, r = 0.34 and r = 0.43, p 0.05). CONCLUSIONS: In the treatment of patients with full-thickness macular holes, there is a significant relationship between changes in retinal perfusion and the recovery of visual acuity, retinal sensitivity and bioelectrical activity in the foveal area, and it is more pronounced in the period from 1 to 6 months after macular hole closure. The obtained results suggest a possible prognostic role of OCTA results in the surgical treatment of full-thickness macular holes.