KHẢO SÁT SỰ THAY ĐỔI HỆ VI MẠCH VÕNG MẠC VÙNG HOÀNG ĐIỂM BẰNG MÁY OCT-A TRÊN BỆNH NHÂN LỖ HOÀNG ĐIỂM TOÀN BỘ CHIỀU DÀY VÔ CĂN TRƯỚC VÀ SAU ĐIỀU TRỊ PHẪU THUẬT

Abstract

tomography (OCT) angiography features in patient with idiopathic full-thickness macular hole before and after vitrectomy. Design: Prospective, Longitudinal Study. Participants: 36 eyes of 36 patients with idiopathic full-thickness macular hole were included. Methods: Patients presenting with an idiopathic full-thickness macular hole (IMH) who underwent posterior vitrectomy with internal limiting membrane peeling and gas tamponade were included in the study. En face OCT and OCT angiography (OCTA) were performed pre- and postoperatively using 3×3 mm scans. Foveal avascular zone (FAZ) area, macular hole size (MHS), central retinal thickness (CRT) and fovea vessel density (FVDS) were measured and assessed using OCTA. Best corrected visual acuity (BCVA) was examined before and 3 months after surgery. Results: Thirty-six eyes of 36 patients were included in the study. The mean age of patient group was 62.2 years. The hole was closed in all eyes after the initial surgery. OCTA showed enlargement of FAZ and increased CRT in foveal area. Mean preoperative FAZ area was 0.43±0.10 mm². BCVA was improved from 0.82±0.32 preoperatively to 0.50±0.30 postoperatively (LogMAR). Mean FAZ area was reduced to 0.27±0.07 mm² postoperatively with resolution of macular hole. Mean CRT was reduced from 345.10 µm preoperatively to 259.60 µm postoperatively. After vitrectomy, FVDS of IMH eyes increased compared with the preoperative measurements. Conclusions: Quantitative evaluation of vascular and morphological changes following IMH surgery using OCTA shows the potential for recovery due to vascular and neuronal plasticity. OCTA showing vascular changes and their quantitative characteristics might be a useful tool for the assessment of macular holes before and after surgical treatment