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Aylin Karalezli, Sabahattin Sul Muğla Sıtkı Koçman University, Ophthalmology Department Turkey

Foveal microvasculature differences in patients with macular hole after vitrectomy with internal limitant membrane removal or single - layered inverted internal limitant membrane flap technique. Aylin Karalezli, Sabahattin Sul Muğla Sıtkı Koçman University, Ophthalmology Department Turkey

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Aylin Karalezli, Sabahattin Sul Muğla Sıtkı Koçman University, Ophthalmology Department Turkey

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  1. Fovealmicrovasculaturedifferences in patientswithmacular hole aftervitrectomywithinternallimitantmembraneremovalorsingle-layeredinvertedinternallimitantmembraneflaptechnique Aylin Karalezli, Sabahattin Sul Muğla Sıtkı Koçman University, Ophthalmology Department Turkey 19th EVRS Meeting June 2019, Lizbon-Portugal

  2. Purpose • To determine the foveal microvasculature differences in patients with idiopathic macular hole (MH) after vitrectomy with internal limitant membrane (ILM) removal  or single-layered ILM flap technique

  3. Material- Methods • Design: A retrospective, observational case series • Group 1: Fifteen eyes of 15 patients with a unilateral MH that had undergone vitrectomy with ILM removal • Group 2: 7 eyes of 7 MH patients that had undergone vitrectomy with single- layered ILM flap • Control group: healthy fellow eyes • OCTA scan before, 4 and 8 weeks after surgery (3 mm x 3 mm and 6 mm x 6 mm en face images) • The area of the foveal avascular zone (FAZ) and the vascular density (VD) ratio in the superficial and deep capillary plexus (SCP and DCP) were evaluated

  4. Results • no statistically significant differences between the groups for baseline characteristics • mean postoperative FAZ areas were significantly reduced after surgery in two groups (p<0.001) • postoperative FAZ areas were significantly smaller than that of the fellow eye in two groups (p<0.001) • no statistically significant differences in mean postoperative FAZ areas between two groups (p=0.764)

  5. Results • mean VD ratios in SCP were similar (p=0.341 in group1 and p=0.326 in group 2) • mean VD ratios in DCP were statistically lower than that for the fellow eyes after surgery (p=0.021 in group 1 and p=0.032 in group 2) • change in VD ratio in DCP after surgery was higher in group 1 than in group 2, but the difference was not statistically significant (p=0.675)

  6. Pre-postop ILM peeling (Group 1) Pre-postop ILM flab (Group 2)

  7. Group 1 Preop FAZ Prostop FAZ Group 2

  8. Group 1 Preop SCPVD Preop DCPVD Postop SCPVD Postop DCPVD

  9. Group 2 Preop SCPVD Preop DCPVD Postop SCPVD Postop DCPVD

  10. Conclusion • FAZ area and the mean VD ratio of the DCP decrease after the MH surgery • Although the healing process after MH surgery may cause both anatomic and hemodynamic changes of the inner retina,  the single-layered ILM flap technique does not seem to have added any additional microvascular changes on macula when compared with ILM removal

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