The effect of retinal perfusion on the bioelectric activity of the retina in full-thickness macular holes

BACKGROUND: Information on retinal capillary perfusion in idiopathic full-thickness macular hole (FTMH) is limited, and there are no data on the possible effect of blood supply to individual areas and layers of the retina on their functional activity.

AIM: To study the relationship between vascular perfusion in the superficial and deep capillary plexuses (SCP and DCP) and the bioelectrical activity of the retina in full-thickness macular hole.

MATERIALS AND METHODS: Multifocal electroretinography (mfERG), optical coherence tomography (OCT), and OCT-angiography (OCTA) were performed in 18 eyes with FTMH and 10 intact eyes. In the projection of individual hexagons of the mfERG pattern, parameters of bioelectrical activity were compared with structural changes (hole, cystic changes), capillary density in the SCP and DCP.

RESULTS: In the FTMH group, the density of capillaries in the superficial capillary plexuses correlated with P₁ implicit time in the R₂ ring hexagons (R = –0.23, p < 0.05), in the hole zone and intraretinal cystic changes (R = –0.21 and R = –0.22, p < 0.05), P₁ amplitude in the hole zone (R = 0.24, p < 0.05). In deep capillary plexuses, the capillary density correlated with N₁ implicit time at the fixation point and the hole zone (R = –0.57 and R = –0.19, p < 0.05), P₁ implicit time at the hole zone (R = –0.2, p < 0.05), P₁ amplitude in the hexagons of the R₂ and R₃ rings (R = 0.46 and R = 0.44, p < 0.05), more pronounced in the hole zone and cystic changes (R = 0.54 and R = 0.29, p < 0.05).

CONCLUSIONS: There is a correlation between capillary perfusion in different layers of the retina and its bioelectrical activity in FTMH. A decrease in perfusion in the deep capillary plexus of the macula with a chronic macular hole may be a predictor of a low functional prognosis in the outcome of surgical treatment of FTMH.