Ultrastructural analyses of internal limiting membrane excised from highly myopic eyes with myopic traction maculopathy

Purpose

To evaluate the ultrastructure of the internal limiting membranes (ILMs) excised during vitrectomy from highly myopic eyes with myopic traction maculopathy (MTM). The clinical findings before and after the vitrectomy were compared.

Methods

Seven eyes of 7 patients with macular retinoschisis were studied. Four of these eyes also had a foveal detachment but without a retinal break. All the eyes underwent vitrectomy with the creation of a posterior vitreous detachment and ILM peeling. The excised ILMs were examined by transmission electron microscopy (TEM).

Results

The retinas were reattached in all eyes after the vitrectomy. No retinal breaks including macular holes were identified intraoperatively. Transmission electron microscopy showed glial cells in 4 eyes, retinal pigment epithelium-like cells in 4 eyes, and myofibroblast-like cells in 4 eyes on the excised ILMs. A newly produced basement membrane appeared to merge with the ILM in 5 eyes. Thick collagen was seen in 2 eyes, and fibrous long-spacing collagen in the newly synthesized collagen fibers was seen in 3 eyes. The cellular components of the glial cells appeared to have migrated through the thinner parts of the retina or through a defect of the ILM in 2 eyes.

Conclusions

Cells that migrate onto the surface of the ILM synthesize new collagen, which can create tangential traction. This may explain the success of vitrectomy with ILM peeling in treating MTM in highly myopic eyes.

     

Concentration of acute phase factors in vitreous fluid in diabetic macular edema

Purpose

Diabetic retinal maculopathy is associated with acute and chronic local inflammation. We measured the concentrations of acute phase factors in vitreous fluid of patients with diabetic macular edema (DME) and examined their relations to visual acuity and central retinal thickness (CRT) both before and after vitrectomy.

Study design

Retrospective.

Methods

Vitreous fluid was collected during vitreoretinal surgery from 19 patients with DME and 12 control subjects with epiretinal membrane. The concentrations of acute phase factors (α2-macroglobulin, haptoglobin, C-reactive protein, serum amyloid P and A, procalcitonin, ferritin, tissue plasminogen activator, fibrinogen) and vascular endothelial growth factor (VEGF) were measured with multiplex assays. CRT of macular edema was measured by optical coherence tomography (OCT).

Results

The levels of serum amyloid P, procalcitonin, ferritin, and fibrinogen in vitreous fluid were increased in DME patients compared with control subjects. The levels of procalcitonin and fibrinogen in DME patients were inversely correlated with visual acuity both before and 3 months after vitrectomy but not 6 months postsurgery. The concentrations of these four factors were not correlated with either CRT or the vitreous levels of VEGF in DME patients.

Conclusion

Acute phase factors may contribute to local inflammation in DME and may therefore influence disease progression.

     

Surgical outcomes of 27-gauge pars plana vitrectomy with short-term postoperative tamponade of perfluorocarbon liquid for repair of giant retinal tears

Purpose

To investigate the use of 27-gauge pars plana vitrectomy (PPV) with short-term tamponade of perfluorocarbon liquid (PFCL) for repair of giant retinal tears (GRT).

Methods

Retrospective case series study. Consecutive patients with GRT were treated with 27-gauge PPV and short-term tamponade of PFCL for 7–10 days. PFCL was completely removed with a secondary surgery.

Results

Twenty-three eyes of 23 patients were included. All the patients achieved primary anatomic success. Preoperative logarithm of the minimum angle of resolution (logMAR) BCVA was 1.59 ± 0.58 (Snellen 20/778). Five (21.7%), nine (39.1%), eleven (47.8%) and fifteen (65.2%) eyes experienced vision improvement at the Month-1, Month-3, Month-6 and final follow-ups, respectively. The final logMAR BCVA was 0.84 ± 0.51 (Snellen 20/138), being statistically better than the preoperative one (P < 0.001). Surgical complications included foreign body response (n = 7), transient elevated intraocular pressure (n = 5), cataract formation/deterioration (n = 11) and posterior capsule opacity (n = 16).

Conclusions

27-Gauge PPV with short-term tamponade of PFCL is safe and effective for the repair of GRT. Side effects of the surgery mainly included foreign body response, transient elevated intraocular pressure, cataract formation/deterioration and posterior capsule opacity.

     

Retinal thinning after internal limiting membrane peeling for idiopathic macular hole

Purpose

To determine the changes in retinal thickness and whether they correlate with the size of the macular hole (MH) after vitrectomy with internal limiting membrane peeling.

Study design

Retrospective, interventional case series

Methods

Consecutive patients with an MH and undergoing pars plana vitrectomy with internal limiting membrane peeling were studied. The retinal thicknesses in the inner 4 sectors as defined by the Early Treatment of Diabetic Retinopathy Study were measured using spectral-domain optical coherence tomography (SD-OCT) before and at 2 weeks and 1, 3, 6, and 12 months after the surgery. The basal and minimum diameters of the MHs were measured. The correlations between the retinal thicknesses and the size of the MH were determined.

Results

Thirty-three eyes of 32 consecutive patients (18 women; mean age, 64.2 ± 8.8 years) with an MH were studied. Thirteen eyes had a stage-2 MH; 12 eyes, a stage-3 MH; and 8 eyes, a stage-4 MH. The mean retinal thickness in the temporal sector was 362.8 ± 29.9 µm preoperatively, 337.9 ± 20.6 µm at 2 weeks postoperatively, and 307.6 ± 20.2 µm at 12 months postoperatively (P < .001 for both, paired t tests). The respective mean thicknesses in the superior, inferior, and nasal sectors were 373.9 ± 34.9, 367 ± 28.7, and 385.5 ± 35.9 µm preoperatively; 361.6 ± 22.7, 359.4 ± 20.6, and 383.4 ± 29.0 µm at 2 weeks postoperatively (P = .0087, P = .049, P = .635); and 339.4 ± 18.9, 331.6 ± 21.4, and 371.3 ± 23.2 µm at 12 months postoperatively (P < .001, P < .001, P = .033). The changes in the retinal thickness at 2 weeks and 12 months in all 4 sectors were significantly correlated with the basal and minimum diameters of the MH.

Conclusions

Retinal thinning was observed soon after the MH surgery mainly in the temporal sector but also in the superior and inferior sectors. The thinning was greater in eyes with a larger MH, indicating that retinal structures dynamically change after internal limiting membrane peeling.

     

Alemtuzumab-induced remission of multiple sclerosis-associated uveitis

Purpose

The purpose of the study was to report a case of multiple sclerosis (MS)-associated uveitis refractory to conventional immunosuppressants, with subsequent remission following treatment with alemtuzumab.

Methods

Case report Patient was treated with intravenous alemtuzumab, a lymphocyte depleting anti-CD52 monoclonal antibody that has recently been approved for use in relapsing MS.

Results

A 17-year-old female presented with bilateral optic neuritis and subsequently bilateral intermediate uveitis and secondary macular oedema. She was diagnosed with active relapsing MS for which she received treatment with alemtuzumab. The intraocular inflammation previously refractory to conventional immunosuppressants responded to alemtuzumab, inducing remission.

Conclusions

To our knowledge, this is the first such report of alemtuzumab treatment in MS-associated ocular inflammatory disease and may demonstrate a potential utility for this drug in related conditions.

     

Case report of secondary pigment dispersion glaucoma,recurrent uveitis and cystoid macular oedema following inadvertent implantation of an intraocular lens into the ciliary sulcus following cataract surgery

Background

This case highlights the important sequelae that can occur following the inadvertent implantation of a single-piece intraocular lens into the ciliary sulcus during cataract surgery; secondary pigment dispersion glaucoma, recurrent anterior uveitis and macular oedema.

Case presentation

A 67-year-old lady underwent routine left cataract surgery in a separate unit but subsequently attended our eye casualty with recurrent hypertensive anterior uveitis. She was found to have secondary pigment dispersion glaucoma as the intraocular lens had been inadvertently placed into the ciliary sulcus. She underwent a trabeculectomy to control the intraocular pressure and initially settled well but 12 months later developed persistent anterior segment inflammation and macular oedema. She subsequently had the intraocular lens removed and the macular oedema was treated successfully with intravitreal Bevacizumab.

Conclusions

We provide a summary of the evidence and a discussion over the management options available in managing such a difficult case.

     

Associations of macular thickness in spectral-domain OCT with ocular and systemic cardiovascular parameters - The MIPH Eye &amp; Health Study

Purpose

Beyond in-vivo histological analysis of retinal tissue, optical coherence tomography (OCT) allows quantitative image analysis. This study evaluates associations of macular retinal thickness measured with spectral-domain OCT (SD-OCT) and ocular and systemic cardiovascular parameters in adult subjects.

Methods

An epidemiological cross-sectional study was performed in the staff of a European high-tech company. Examination of known cardiovascular risk factors including biochemical blood analysis was performed, and ocular parameters such as refraction, tonometry, SD-OCT imaging of the macula and cornea, and fundus photography were evaluated. Retinal thickness measurements were evaluated according to the ETDRS grid. Associations of macular retinal thickness and systemic cardiovascular and ocular parameters were calculated by multivariate analysis using SPSS software.

Results

Four hundred and twenty-four probands were included. Macular thickness measurement were significantly associated with gender and refraction. Female persons had thinner retinal thickness in all zones. Macular thickness decreased with increasing myopia in all perifoveal measurements. Outer perifoveal measurements were associated with keratometry; a flatter corneal radius was linked to a thinner retina. Tonometry and systemic cardiovascular risk factors were not associated with macular retinal thickness in multivariate analysis (p?>?0.05).

Conclusions

Macular retinal thickness is associated with refraction and gender; cardiovascular risk factors or tonometry do not influence macular retinal thickness measurements. Keratometry might influence outer zone measurements. Our findings provide a dataset for quantitative evaluation of SD-OCT, and evaluate influencing factors.

     

Blood coagulation parameters after intravitreal injection of aflibercept in patients with neovascular age-related macular degeneration

Purpose

The aim of this study was to evaluate the effect of intravitreal injection of aflibercept (IVA) on blood coagulation tests in neovascular age-related macular degeneration (AMD) patients.

Methods

Thirty-four patients with neovascular AMD (study group) and 32 healthy individuals (control group) were enrolled. Prothrombin time (PT) and activated partial thromboplastin time (aPTT) were measured at different times in patients with neovascular AMD.

Results

The levels of PT and aPTT after IVA were decreased at 1 month after the first injection and 1 month after the second injection compared to the baseline measurement in the study group.

Conclusions

IVA may cause a decrease in the levels of PT and aPTT at 1 month after the first injection and 1 month after the second injection although these results are not statistically significant in our study.

     

Subretinal injection of recombinant tissue plasminogen activator for submacular hemorrhage associated with ruptured retinal arterial macroaneurysm

Purpose

To evaluate the surgical outcomes of small-gauge vitrectomy with subretinal injection of recombinant tissue plasminogen activator (rt-PA) for a submacular hemorrhage caused by a ruptured retinal arterial macroaneurysm (RAM).

Methods

Non-comparative, consecutive case-series performed at two ophthalmological institutions. We examined 22 eyes of 22 patients with a submacular hemorrhage associated with a RAM but without a preretinal or sub-internal limiting membrane hemorrhage at the fovea. During 25-gauge vitrectomy, approximately 4000–8000 IU of rt-PA was injected subretinally, followed by the injection of air or 10 % sulfur hexafluoride as a tamponade. The patients maintained an upright position for 1 hour, then turned to a facedown position for 1 to 3 days. The best-corrected visual acuity (BCVA) and postoperative complications were evaluated.

Results

The average interval from the onset of symptoms to surgery was 8.4?±?7.6 days, and the average size of the subretinal hemorrhage was 3.4?±?1.0 disc diameters. The submacular hemorrhage was displaced from the foveal area in all eyes after 1 week. The mean baseline BCVA was 1.41?±?0.41 logMAR units, and it improved to 0.91?±?0.43 at 1 month and to 0.64?±?0.45 at the final visit (P?=?0.0001, P?<?0.0001 respectively). A macular hole was detected intraoperatively in two eyes and postoperatively in two eyes, and both were closed by internal limiting membrane peeling or a second vitrectomy.

Conclusions

Small-gauge vitrectomy with subretinal rt-PA injection and gas tamponade were effective in displacing a submacular hemorrhage associated with a RAM.

     

Topical non-steroidal anti-inflammatory drugs for the treatment of cystoid macular edema post Descemet’s stripping automated endothelial keratoplasty

Purpose

To investigate the effectiveness of topical non-steroidal anti-inflammatory drugs (NSAIDs) in the treatment of cystoid macular edema (CME) post Descemet’s stripping automated endothelial keratoplasty (DSAEK).

Study design

Retrospective observational study

Methods

In this study of 334 patients who underwent DSAEK at the Baptist Eye Institute, Kyoto, Japan between July 2011 and December 2015, 18 patients with postoperative CME (determined by optical coherence tomography) treated with topical NSAIDs after the onset of CME were included.

Results

At CME onset, 17 of the 18 patients were treated with bromfenac eye drops and 1 was treated with nepafenac eye drops. Post initiation of treatment with topical NSAIDs, CME in 17 (94.4%) of the 18 patients improved at 1 month and all cases completely recovered within 3 months. At 12-months post initiation of treatment, 61.1% (n?=?11) of patients achieved a visual acuity (VA) of 20/40 or better, and there was no significant difference of VA between the patients with or without an episode of postoperative CME (P?=?0.55).

Conclusion

The administration of topical NSAID eye drops was found to be effective in treating patients with CME post DSAEK.

     

Bevacizumab dosing every 2 weeks for neovascular age-related macular degeneration refractory to monthly dosing

Purpose:

To evaluate intravitreal bevacizumab every 2 weeks (biweekly) in refractory neovascular age-related macular degeneration (nAMD).

Study design:

Retrospective study.

Methods:

A retrospective study of consecutive nAMD patients unresponsive to monthly intravitreal anti-vascular endothelial growth factor (VEGF) switched to 3–4 biweekly injections.

Results:

Twenty-seven eyes of patients aged 82.08 ?± 6.85 years were included. Prior to the 2-week interval bevacizumab injections, 74.1% (n=20) were treated with both bevacizumab and ranibizumab, 11.1% (3 eyes) also received aflibercept and 14.8% (4 eyes) had received prior treatment of monthly bevacizumab (average number of injections 21.5 ± 6.7). Best corrected visual acuity (BCVA) remained stable between baseline (logMAR 0.72± 0.60) and follow-up (0.76± 0.66) (p=0.41). Mean central macular thickness and macular volume did not change significantly between baseline and follow-up (p=0.35 and p=0.60, respectively). Six eyes (22.2%) showed morphologic anatomic improvements, while 19 eyes (70.4%) were stable and two eyes (7.4%) deteriorated from baseline. Subretinal fluid completely resolved in 3 of the eyes and improved in the other 3 eyes and in this group (22.2%) both central macular thickness (326.2 ± 101.4 versus 297.5 ± 97.2, p=0.002) and macular volume (8.69 ± 1.69 versus 8.22 ± 1.43, p=0.03) were significantly reduced. No adverse events were observed in any of the treated eyes.

Conclusion:

This study demonstrates that biweekly bevacizumab injections are effective in nearly one-quarter of nAMD non-responders with no adverse events reported. Switching earlier, rather than later, to this low cost modality may be of benefit for a portion of non-responders to conventional treatment.

     

Comparison of changes of macular ganglion cell-inner plexiform layer defect between stable group and progression group in primary open-angle glaucoma

Purpose

To compare the changes in macular ganglion cell-inner plexiform layer (GCIPL) defect between stable and progression primary open-angle glaucoma (POAG) groups.

Study design

Retrospective observational study.

Methods

A total of 100 POAG eyes with localized retinal nerve fiber layer (RNFL) defect and corresponding macular GCIPL defect were selected for this study. Glaucoma progression was defined by either structural or functional deterioration. The number of abnormal superpixels on macular GCIPL deviation maps was calculated using a customized MATLAB program. GCIPL defect change was evaluated in two aspects: increased angular width and increased area. The defect patterns were categorized and compared between the stable and progression groups.

Results

The increase rate of angular width of GCIPL defect was higher in the progression group than in the stable group (P = 0.029). In respect to the area of GCIPL defect, there was no statistically significant differences between the groups (P = 0.227). Twenty-seven (27) of 100 (27.0%) eyes showed increased angular width of GCIPL defect. It was more frequent in the progression group than in the stable group (P = 0.043). Seventeen (17) of 27 (63.0%) eyes showed the away from the horizontal temporal raphe type progression and it was the most common change pattern of angular width of GCIPL defect.

Conclusions

Increased angular width of GCIPL defect was the more prominent feature of change, and was more frequent in the progression group than in the stable group. Among the types of GCIPL defect classified, the away from the horizontal temporal raphe type was the most common.

     

Surgical treatments for fibrous tissue extending to the posterior retina in eyes with familial exudative vitreoretinopathy

Purpose

To describe the clinical features and surgical outcomes of macular dragging or tractional retinal detachment that occurred as a result of fibrovascular tissue (FT) progression toward the posterior retina in eyes with familial exudative vitreoretinopathy (FEVR).

Methods

The medical records of 4 patients (2 girls, 2 boys) with FEVR were reviewed retrospectively.

Results

All 4 patients had retinal dragging or radial retinal folds with FT in the peripheral retina in at least 1 eye at the initial visit. During the follow-up period, all the patients had FT that progressed toward the posterior pole and developed from the peripheral FT, resulting in macular dragging or posterior tractional retinal detachment. Vitrectomy with or without scleral buckling and laser photocoagulation were performed in all 4 cases, with removal of the FT in the posterior pole and segmentation of the FT between the posterior and peripheral FT. The traction resolved postoperatively and the retina extended in all 4 cases.

Conclusions

In 4 cases with FEVR, the FT developed from the peripheral FT, progressed toward the posterior retina, and generated traction. Vitrectomy with focal removal and segmentation of the FT in the posterior pole might be a good surgical option in such eyes.

     

Macular function in preterm children at school age

Purpose

Macular development is a complex process that starts by mid-gestation and continues several years after birth. A preterm birth could affect this development, causing increased thickness in the central macula, but the effect of the macular function remains uncertain. The aim of this study was to investigate the macular function measured with multifocal electroretinography (mfERG), in former preterm children and compare with healthy controls. A second aim was to correlate central macular function with central macular thickness measured with optical coherent tomography (OCT), in the preterm group.

Methods

Fifteen former preterm children born before 32 weeks of gestation were included in the study. MfERG results from 12 children acted as controls. Visual acuity, refraction in cycloplegia and mfERG were carried out in all children, and optical coherent tomography (OCT) was performed in the preterm children. Main outcomes were P1 amplitudes and implicit times for Rings 1–5 and “sum of groups” of the mfERG, and central macula thickness in area A1 measured with OCT.

Results

The P1 amplitudes were reduced in Rings 1–5 and “Sum of groups” in the preterm children compared to controls. There were no significant correlation between P1 amplitude or implicit times in Ring 1 and central macular thickness in the preterm group.

Conclusions

Macular function is reduced in former preterm children compared to children born at term. This suggests that the structural changes with a thicker central retina can have an effect on function and may be one, of probably several, explanations for visual dysfunction in preterm children at school age.

     

Electrophysiological features and multimodal imaging in ritonavir-related maculopathy

Purpose

The purpose of this study is to report a case of ritonavir-related retinal toxicity followed over a year. Electrophysiological features and multimodal imaging, including adaptive optics, are provided and discussed.

Methods

Electrophysiological recordings and multimodal imaging were performed and repeated over 1 year.

Results

Fundus examination revealed crystalline maculopathy in conjunction with pigment disruption. Spectral domain optical coherence tomography displayed thinning of the macula without cysts. Autofluorescence imaging revealed a mixed pattern of complete loss of the autofluorescence in the area of retinal pigment deposit and an increased transmission of the autofluorescence in the area of retinal thinning. Fluorescein angiography ruled out parafoveal telangiectasia. Indocyanine green angiography was not contributive. Increased spacing of the macular cone mosaic, crystal deposits and pigment migrations were seen with adaptive optics. Full-field electroretinogram was slightly reduced for both eyes, especially in the light-adapted responses, and mfERG confirmed bilateral maculopathy. Functional and structural abnormalities did not change with follow-up besides constant pigmentary changes monitored with adaptive optics.

Conclusion

Ritonavir-related retinal toxicity is a maculopathy with peculiar features including crystalline and pigment migration associated with central or temporofoveolar thinning and inconstant macular telangiectasia. Despite drug cessation, retinal remodelling continues to progress.

     

Rare retinal complications of bone marrow transplantation (BMT): a case report

Background

Bone marrow transplantation retinopathy is a rare condition affecting the posterior pole. The purpose of this case report is to highlight the possible risk factors and clinical features.

Case presentation

A 19y old male with relapsed and refractory acute lymphoblastic leukaemia was admitted under haematology with pyrexia of unknown origin. At the time of his admission, he reported bilateral and sequential visual impairment for 2 days. On examination, there was bilateral profound retinopathy across the posterior poles. This was symmetrical and with associated macular oedema. Infective aetiology was excluded and cyclosporine was stopped. Although no definitive treatment was initiated the visual acuity improved whilst macular oedema fluctuated.

Conclusion

BMT and chemotherapy can cause ocular complications but these are usually confined to the anterior segment. Posterior segment complications in the form of retinopathy is very rare. We report this case to highlight some of the clinical features and course of disease.

     

Acute visual loss and intraretinal hemorrhages associated to energy drink consumption

Purpose

To report the association of acute visual loss secondary to intraretinal hemorrhages and energy drink consumption.

Methods

Case report and literature review.

Results

A 48-year-old hypertensive man developed an elevation in systemic blood pressure, tachycardia, and acute visual loss secondary to intraretinal hemorrhages shortly after drinking several cans of energy drinks.

Conclusion

High consumption of energy drinks may lead to intraretinal hemorrhages and acute visual loss.

     

Two cases of repeating recurrences and spontaneous closures of macular holes in vitrectomized eyes

Background

Three eyes of 2 cases had repeating recurrences and spontaneous closures of macular holes (MHs) after vitrectomy.

Cases

A 66-year-old man had rhegmatogenous retinal detachment (RRD) in his left eye and underwent vitrectomy with successful retinal reattachment. A full-thickness MH developed 1 year after the vitrectomy and spontaneously closed 1 month later. Opening and spontaneous closure of the MH recurred an additional 4 times over 7 years. An 80-year-old man had suffered intraocular lens (IOL) dislocation and underwent vitrectomy in his left eye. An MH developed in the eye 6 years and 3 months after the vitrectomy. Repeated opening and spontaneous closure of the MH occurred twice in the left eye. The same patient also suffered IOL dislocation and underwent vitrectomy in his right eye. An MH also developed in the right eye 2 years and 9 months after the vitrectomy. Repeated opening and spontaneous closure of the MH occurred 3 times in the right eye.

Observations

The visual acuity was maintained at the last visit in both cases.

Conclusions

MHs in vitrectomized eyes can show repeated recurrence and spontaneous closure.

     

Microvascular changes after vitrectomy with internal limiting membrane peeling: an optical coherence tomography angiography study

Purpose

To evaluate superficial capillary plexus (SCP) changes occurring after internal limiting membrane (ILM) peeling for the treatment of idiopathic epiretinal membrane (ERM).

Methods

A total of 15 eyes of 15 patients affected by idiopathic ERM (eight males and seven females; mean age 59.8 ± 9.6 years) were enrolled in the study. Patients were treated with pars plana vitrectomy followed by ERM and ILM peeling. Subjects were evaluated at baseline and at the week-1 and month-1 follow-up visits. At each visit, patients were evaluated with a complete ophthalmologic evaluation, which included imaging with optical coherence tomography angiography.

Results

Overall, the SCP vessel density was 43.0 ± 3.0% at baseline and was stable throughout the follow-up (40.0 ± 4.0% at week-1 and 41.0 ± 4.0% at month-1 follow-up visits; p = 0.087 and p = 0.426, respectively). Nevertheless, the SCP vessel density was reduced at week-1 visit in both the superior and inferior sectors. In these sectors, the superficial vessel density was still reduced at the month-1 follow-up visit.

Conclusions

We observed a reduction in the SCP vessel density occurring after pars plana vitrectomy with ILM peeling. The reduction is referred to those areas where other changes (e.g., swelling of the arcuate nerve fiber layer) have been already described. In theory, superficial vessel density modifications may be due to the direct surgical trauma to the inner retina, where the superficial plexus is contained, during the ILM grasping.

     

Changes in the size of the foveal avascular zone after vitrectomy with internal limiting membrane peeling for a macular hole

Purpose

To determine the size of the foveal avascular zone (FAZ) before and after vitrectomy for a macular hole (MH).

Study Design

Retrospective case series study.

Methods

Twenty-five eyes of 25 patients with a unilateral MH that had undergone vitrectomy with internal limiting membrane peeling were studied. The unaffected 17 fellow eyes were studied in the same way. En face images of the parafoveal region were obtained by optical coherence tomography angiography, and the images were used to measure the FAZ before and 1 month after the vitrectomy. The relationships between the different FAZ sizes and the ocular parameters were determined by Pearson product moment correlation analysis.

Results

Compared with the preoperative superficial FAZ (sFAZ), the postoperative sFAZ was significantly reduced (P < 0.001). The postoperative sFAZ was significantly smaller than that of the fellow eye (P < 0.001). The size of the postoperative sFAZ was significantly correlated with that of the preoperative sFAZ, the postoperative foveal thickness (FT), and the sFAZ of the fellow eyes (r = 0.520, P = 0.008; r = ?0.515, P = 0.012; and r = 0.702, P = 0.002, respectively). The size of the postoperative deep FAZ (dFAZ) was significantly correlated with the postoperative FT and the dFAZ of the fellow eyes (r = ?0.441, P = 0.035; and r = 0.499, P = 0.049, respectively). However, no significant correlation was found between the size of the postoperative FAZ and the size of the preoperative MH.

Conclusions

MH closure leads to a significant decrease in the size of the FAZ symmetrical to the size of the fellow eye. The size of the postoperative FAZ is influenced by the postoperative FT independently of the size of the MH.