Secondary Logo

Journal Logo

Institutional members access full text with Ovid®


Michalewska, Zofia MD, PhD; Nawrocki, Jerzy MD, PhD

doi: 10.1097/IAE.0000000000002199
Original Study

Purpose: To describe morphology of retinal and choroidal vessels in swept-source optical coherence tomography angiography before and after vitrectomy with the temporal inverted internal limiting membrane (ILM) flap technique for full-thickness macular holes.

Methods: Prospective, observational study of 36 eyes of 33 patients with full-thickness macular holes swept-source optical coherence tomography angiography was performed in patients before and 1 month after vitrectomy. Vitrectomy with the temporal inverted ILM flap technique was performed. In this method, ILM is peeled only at one side of the fovea. An ILM flap is created to cover the macular hole. Comparison of retina vasculature in the areas of ILM peeling vs. no ILM peeling at 1 and 3 months after successful vitrectomy was performed.

Results: The study demonstrated lower density of vessels in the deep retinal plexus in the area where ILM was peeled as compared to the rest of the fovea. Visual acuity and central retinal thickness 1 month after surgery correlates with fovea avascular zone diameter in deep retinal layers at the same time point (P = 0.001).

Conclusion: This study confirmed that ILM peeling might alter blood flow in deep retinal vessels below the peeling area in the early postoperative period. The area of the fovea avascular zone corresponds to functional results at the same time point.

In the area where internal limiting membrane was peeled, the vessel density is decreased in deep retina vessels plexus in swept-source optical coherence tomography angiography. Fovea avascular zone in deep retinal vessels plexus corresponds to final visual acuity and central retinal thickness.

Ophthalmic Clinic “Jasne Blonia”, Lodz, Poland.

Reprint requests: Zofia Michalewska, MD, PhD, Klinika Okulistyczna “Jasne Blonia”. ul. Rojna 90, Lodz 91-162, Poland; e-mail:

None of the authors has any financial/conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.