Choriocapillaris layer imaging with swept-source optical coherence tomography angiography in lamellar and full-thickness macular hole

Purpose: To present characteristics of choriocapillaris layer imaging with swept-source optical coherence tomography angiography (SS-OCTA) in eyes with macular hole (MH). Methods: Patients with MH were included. Vascular density of choriocapillaris (VDC) and central flow void areas were obtained using SS-OCTA. Data were compared with age- and gender-matched normal controls. Results: Fifty-one patients with MH and 51 controls were included. Among the 51 patients with MH, 19 had lamellar MH (LMH) and 32 had full-thickness MH (FTMH). While VDC in LMH (79.26 ± 4.06%) was not significantly different from that seen in fellow eyes (79.88 ± 4.28%, P = 0.729) and normal controls (80.53 ± 4.21%, P = 1.000), VDC in surgically closed FTMH (74.60 ± 7.37%) was similar to that of fellow eyes (75.45 ± 7.39%, P = 0.400) but lower than that of controls (78.37 ± 7.13%, P = 0.011). On univariate analysis of 32 patients with unilateral sealed FTMH, VDC was not correlated with basal hole area (P = 0.797) or preoperative area of disrupted ellipsoid zone (P = 0.863). Central flow void was detected in 32 eyes. Mean central flow void area was 0.82 ± 0.84 mm², which correlated with preoperative area of disrupted ellipsoid zone (P = 0.001). Conclusions: Choriocapillaris layer imaging using SS-OCTA showed that choriocapillaris in both eyes of patients with unilateral FTMH had different characteristics from eyes with LMH or normal controls. These results suggest that variation in choriocapillaris layer flow is involved in the pathogenesis of MH.