Macular Displacement After Vitrectomy in Eyes With Idiopathic Macular Hole Determined by Optical Coherence Tomography Angiography

Purpose: To determine whether the macula is displaced after vitrectomy with internal limiting membrane (ILM) peeling in eyes with an idiopathic macular hole. Design: A retrospective, observational case series. Methods: Optical coherence tomography angiography was used to obtain 3 mm × 3 mm en face images before and 2, 4, and 8 weeks after the vitrectomy with ILM peeling for 20 eyes of 20 patients with an idiopathic macular hole. The displacements of easily identifiable retinal vessel bifurcations were measured relative to the fovea and the optic disc. Results: The distance between the optic disc and vessel bifurcations was significantly shorter in all 4 quadrants throughout the postoperative period (P <.001). This distance was significantly greater in the temporal quadrant (P <.001). The distance of the bifurcations was significantly correlated with the preoperative distance from the optic disc (r = −0.579, P <.001). A significantly greater downward displacement was observed in the superior quadrant (P <.001). The change in the angle of bifurcations was significantly correlated with the preoperative angle to the optic disc (r = −0.632, P <.001). The change in the distance in the inner region was significantly greater than that in the outer region in all quadrants. A significant reduction was observed in the mean foveal avascular zone area during the follow-up period. Conclusions: The retina in the macular region was displaced nasally, probably owing to movement of the retina toward the optic disc because of a contraction after the ILM removal. There is also a possibility of a rotation downward by buoyancy from gas tamponade, and centripetal contraction during the process of hole closure.