Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(3):248-255 | DOI: 10.5507/bp.2023.017

Changes in vascular density in the macula after pars plana vitrectomy for idiopathic macular hole with macular peeling and one type of flap

Anna Tarkova^{1, 2, 3}, Nada Jiraskova^{2, 3}, Jaroslava Dusova², Jan Marak², Jan Studnicka^{2, 3}

¹ Department of Ophthalmology, Faculty Hospital Nitra, Spitalska 6, Nitra, Slovak Republic

² Department of Ophthalmology, University Hospital Hradec Kralove, Sokolska 581, Hradec Kralove, Czech Republic

³ Department of Ophthalmology, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic

Background and Aims: The aim of this study was to evaluate changes in vascular density in the macula after pars plana vitrectomy for idiopathic macular hole (IMD) with macular peeling and flap.

Methods: A prospective study of 35 eyes in 34 patients who had undergone standard surgery. Evaluated parameters were best-corrected visual acuity (BCVA), intraocular pressure (IOP), central macular thickness (CRT), macular volume (TMV) and vascular density of the superficial and deep capillary plexus. The follow-up period was one year.

Results: We divided the total group into two: temporal and circular flap and total group. We compared the values after surgery with the preoperative values. In the total group, BCVA increased from 48.38 to 71.44 letters (P≤0.05). IOP changed from 15.24 to 14.76 mmHg (P>0.05). CRT decreased from 432.27 to 323.64 µm (P≤0.05). TMV changed from 0.26 to 0.25 mm3 (P>0.05). The vascular density of the superficial plexus decreased from 32 to 28% (P≤0.05). The intercapillary space of the superficial plexus increased from 68 to 72% (P≤0.05). The vascular density of the deep plexus increased from 17 to 23%. The intercapillary space of the deep vascular plexus decreased from 83 to 77%. Changes in vascular density and intercapillary space of the deep plexus were statistically significant for certain months after operations (P≤0.05). There were no significant differences between subgroups.

Conclusion: The superficial plexus vascular density is almost the same in the temporal flap and in the foveal-sparing flap is decreased, and the deep plexus vascular density increased statistically significantly during the follow-up period after surgery.

Keywords: macular hole, pars plana vitrectomy, foveal-sparing flap, temporal flap, deep vascular plexus, superficial vascular plexus

Received: January 16, 2023; Revised: April 13, 2023; Accepted: April 21, 2023; Prepublished online: April 28, 2023; Published: September 12, 2024  Show citation