Effects of physiological fluctuations on the estimation of vascular flow in eyes with idiopathic macular pucker.

Objectives: To evaluate the macular vascular flow in eyes with idiopathic macular pucker (Eye), pre and post pars plana vitrectomy with epiretinal and limiting membranes peeling, and to compare it with the vascular flow in the healthy fellow eyes (Eye), taken as physiological reference value.

Methods: 40 eyes of 40 patients were recruited. Best-corrected visual acuity (BCVA) was evaluated. Spectral domain optical coherence tomography (SD-OCT) and OCT-angiography parameters were central foveal thickness (CFT), choroidal thickness (CT), foveal avascular zone (FAZ) area, vessel area density (VAD), vessel length fraction (VLF), vessel density index (VDI) of superficial capillary plexus (SCP) and deep vascular complex (DVC), choriocapillaris (CC) flow. Absolute and relative difference calculation was applied to evaluate macular vascular flow in Eye adjusted for physiological changes detected in Eye.

Follow-up: 6 months.

Results: BCVA improved (p = 0.003) in all cases following surgery. CFT reduced postoperatively (p = 0.0138). FAZ area was smaller in Eye than Eye (p = 0.0071) preoperatively and postoperatively it shrank further (p = 0.0027). After surgery, inverse correlation between FAZ area and BCVA was detected (r-0.683). VAD of SCP was pre- and post-operatively higher in Eye than Eye (baseline p = 0.0344, 6th month p = 0.0466). Relative difference of VDI of SCP (p = 0.0096) and CC flow (p = 0.0013) at 6 months reduced. DVC flow changed significantly only in Eye. CT increased post-operatively in both Eyei (p = 0.0345) and Eye (p = 0.00423), but relative difference did not change.

Conclusions: Vascular flow indices monitoring demonstrated significant changes in both eyes: Eye and Eye. Relative difference of vascular flow provided objective estimate of changes due to iMP surgery taking into account physiological changes in Eye.