Relationship between the foveal avascular zone and visual function before and after surgery for idiopathic macular hole

Author: Takumi Ando (Japan)

Co-authors: Hiroko Terashima, Hiruma Hasebe, Eriko Ueda, Hiromitsu Yoshida, Takeo Fukuchi

Purpose

To investigate the relationship between the foveal avascular zone (FAZ) and visual function before and after vitrectomy for idiopathic macular hole (MH)

Setting/Venue

This study is a retrospective, interventional case series performed at the Niigata University hospital.

Methods

Twenty-three eyes of 22 MH patients (8 males and 14 females) who underwent successful 25G vitrectomy with internal limiting membrane peeling between April 2019 and January 2021 at Niigata University Hospital were assessed. The mean age was 64.9 ± 7.5 years. To evaluate the superficial FAZ area, 3 × 3 mm optical coherence tomography angiography images were obtained before and three months after surgery. The FAZ change ratio was defined as {(postoperative FAZ area - preoperative FAZ area)/preoperative FAZ area} × 100%, and its correlation with the degree of visual acuity change at three months after surgery was investigated. In addition, microperimetry (10-2 program) was measured before and three months after surgery, and the correlation between the FAZ change ratio and the amount of change in the mean central retinal sensitivity at four points within the central two degrees was examined.

Results

The preoperative FAZ area of 0.42 ± 0.08 mm2 was significantly reduced to 0.24 ± 0.07 mm2 at three months postoperatively (p < 0.001). The mean logMAR visual acuity improved significantly from 0.52 ± 0.20 preoperatively to 0.12 ± 0.16 at 3 months postoperatively (p < 0.001). The mean central retinal sensitivity improved significantly from 22.76 ± 2.41 dB preoperatively to 26.81 ± 0.90 dB at three months postoperatively (p < 0.001). At three months after surgery, the mean FAZ change ratio (-41.74 ± 18.51%) was significantly correlated with the improvement in the mean visual acuity and mean central retinal sensitivity (r = 0.58, p = 0.004; r = -0.58, p = 0.012, respectively).

Conlusions

After MH closure, the greater the contraction of the postoperative FAZ, the better the visual acuity and central retinal sensitivity; therefore, postoperative FAZ evaluation can be a prognostic indicator for postoperative visual function.

Financial Disclosure

I have no financial relations with specific companies