Analysis of choroidal features to predict surgical prognosis of idiopathic macular hole

Objective To investigate choroidal features of idiopathic macular hole (IMH) and determine their relationship with surgical outcomes. Materials and methods Patients above stage II unilateral IMH who received pars plana vitrectomy (PPV) with the internal limiting membrane (ILM) peeling were enrolled for the retrospective observational study. Preoperative choriocapillaris perfusion (CCP), central choroidal thickness (CCT), base/minimum diameters (BD/MD) and height (HH) of MH were analyzed by optical coherence tomography angiography (OCTA). At 1, 3 and 6 months after PPV, CCT, central foveal thickness (CFT) and maximum parafoveal thickness (MPT) of closed MH were measured. Best-corrected visual acuity (BCVA) was assessed at every visit. The correlations between preoperative characteristics and surgical outcomes were assessed. Results Twenty-seven patients were evaluated. All eyes (100%) showed successful MH closure after the primary surgery. Until postoperative 6 months, BCVA continued to improve significantly ( p < 0.001), while CFT and CCT progressively thinned ( p < 0.001, p < 0.001). On correlation tests, final postoperative BCVA was associated with preoperative BCVA (R = 0.506, p = 0.007) and CCP (R = -0.475, p = 0.012), while final CFT was related with preoperative CCT (R = 0.392, p = 0.043). Multiple regression analysis revealed that preoperative CCP was significantly related with final postoperative BCVA (β = -0.403, p = 0.049). Conclusion Preoperative CCP and CCT were respectively associated with functional and anatomical prognosis of IMH after PPV.