Color perfusion maps in macular hole patients treated with pars plana vitrectomy and inner limiting membrane peeling

Purpose : To correlate optical coherence tomography (OCT) features with color perfusion maps in macular hole (MH) patients treated with pars plana vitrectomy (PPV) and inner limiting membrane (ILM) peeling. Methods : Patients with MH who underwent three-port PPV with inverted ILM flap technique were included in this retrospective study. A complete ophthalmic examination, including best corrected visual acuity, B-scan and C-scan en-face OCT, as well as OCT angiography (OCTA), was performed. Postoperatively, the vascular density (VD) values of the superficial and deep capillary plexus (SCP and DCP) were measured using AngioAnalytics software and correlated with OCT findings. Results : A total of 38 eyes of 38 MH patients (16 males, 22 females; mean age: 69.0±6.88 years) treated with PPV and inverted flap technique, were enrolled. All study eyes were followed-up by using a multimodal imaging approach for a mean of 25.2±3.2 months after surgery. Anatomical MH closure was achieved in 37 (97.4%) eyes. At the last follow-up examination, C-scan en-face OCT revealed the presence of temporal concentric macular dark spots (CMDS) in 34 (89.4%) eyes in the SCP and in 10 (26.3%) eyes in the DCP. CMDS perfectly corresponded to dehiscences in the retinal nerve fiber layer on B-scan OCT and appeared as roundish ischemic areas in the SCP and DCP color perfusion maps automatically generated by the OCTA. A significant difference was found between the nasal and temporal regions of the SCP, in terms of VD (p<0.0001). Conclusions : CMDS following ILM peeling for MH surgery perfectly correspond to roundish ischemia regions in OCTA color perfusion maps of both capillary plexuses.