The Role of Angio-Optical Coherent Tomography in the Surgical Management of the Vitreoretinal Interface

Optical coherence tomography angiography (OCT-A) is a noninvasive diagnostic method for three-dimensional visualization of the vascular structures of the retina and choroid. The aim of this study was to evaluate the diagnostic role of OCT-A preoperatively and postoperatively in vitreoretinal interface (VRI) pathologies, by determining the size of the foveal avascular zone (FAZ) in the superficial (SCP) and deep capillary plexus (DCP) and to compare these parameters with control (healthy) eyes. Medical records of 19 patients were prospectively analyzed: nine with a full-thickness macular hole (FTMH) and ten with an idiopathic epiretinal membrane (ERM). All participants underwent unilateral Pars Plana Vitrectomy, peeling of internal limiting membrane and fluid-gas exchange tamponade. The FAZ area of the SCP and DCP was statistically significantly different preoperatively and postoperatively at the 1st month in the FTMH group (0.5311 +/- 0.276 mm(2) vs. 0.4278 +/- 0.257 mm(2), p-value .000; 1.4822 +/- 0.727 mm(2) vs. 0.5856 +/- 0.498 mm(2) p-value .005). The mean preoperative FAZ in both plexuses was bigger compared to the control eyes. The FAZ area of the SCP and DCP was nonsignificantly different preoperatively and postoperatively in patients with ERM, despite a decrease in the mean FAZ area at the 1st month (0.3120 +/- 0.1134 mm(2) vs. 0.2300 +/- 0.1158 mm(2), p-value .150; 0.7100 +/- 0.6607 vs. 0.5190 +/- 0.5591 mm(2), p-value .091). The results of this prospective study suggest that OCT-A is an effective and safe method in VRI pathologies, giving a valuable information for surgical outcome. Due to its high diagnostic value, the prognosis for the recovery of visual function after surgical treatment can be assessed.