The Role of Macular Perfusion as a Contributing Factor in the Pathogenesis of Myopic Macular Traction Maculopathy

Recently, qualitative and quantitative perfusional evaluations of vessel density (VD) and choriocapillaris flow patterns at the macular level have changed the evaluation spectrum and management of different macular pathologies. Published data on long-term macular perfusional findings and quantitative VD and flow evaluation (perfusion indices) in patients at different stages of successfully operated myopic traction maculopathy (MTM) compared with the corresponding values in normal control subjects are limited. This chapter describes the role of macular perfusion as a contributing factor to the pathogenesis of MTM.

The primary outcome measure included the long-term structural and perfusional macular status across groups. Forty-six eyes of 34 patients were included in the study group. The axial length was 29.89±1.67 mm. The postoperative follow-up period was 43±26.77 months. The preoperative BCVA was 1.29±0.54 logMAR, and the postoperative BCVA was 0.60±0.52 logMAR (P<0.05). The difference in perfusion indices across groups was statistically significant (p<0.005). Surgically resolved MTM eyes generally had a larger superficial foveal avascular zone area, lower vessel density, smaller choriocapillaris flow area (CFA), thinner central subfoveal thickness (CSFT), and more macular defects. Better functional, structural, and perfusion index outcomes were observed in highly myopic eyes that underwent early surgery. 

Keywords: Autologous retina grafting, Choriocapillaris flow area, Choriocapillaris subfoveal plexus, Deep vascular plexus, Foveal avascular zone, Foveoretinal detachment, High myopia, Myopic foveoschisis, Myopic macular degeneration, Myopic macular hole, Myopic macular hole-associated retinal detachment, Myopic traction maculopathy, Perfusion indices, Superficial vascular plexus, Vessel density.