Influence of Foveal Avascular Zone on Postoperative Visual Acuity in Macular Hole Surgery

Abstract Background: To investigate the correlation between the pre- and post-operative foveal avascular zone (FAZ) area and visual acuity in patients with idiopathic macular hole (IMH). Methods: Optical coherence tomography angiography (OCTA) was used to measure the values of the pre- and post-operative FAZ in IMH patients, and all patients were followed up for at least 3 months with changes in visual acuity recorded. Results: A total of 30 IMH patients were included, 13 males and 17 females. All patients showed varying degrees of improvement in visual acuity after surgery. The correlation analysis results showed that the preoperative superficial, deep, and full-thickness FAZ were closely related to the best-corrected visual acuity at 3 months after surgery (r=0.521, 0.605, and 0.704, P＜0.05, ＜0.01, and ＜0.01), with the deep and full-thickness FAZ showing a more significant correlation than the superficial FAZ. At 1 week after surgery, the superficial, deep, and full-thickness FAZ showed significant differences compared to the preoperative values (t=4.8, P＜0.01, t=7.1, P＜0.01, and t=4.4, P＜0.01). At 1 month after surgery, the superficial, deep, and full-thickness FAZ showed significant differences compared to each layer's FAZ at 1 week after surgery (t=-2.1, P=0.046, t=-2.9, P＜0.01, and t=-4.1, P＜0.01). Conclusion: There is a correlation between preoperative FAZ and postoperative visual acuity in IMH patients, with smaller preoperative FAZ associated with better postoperative visual acuity recovery.