EC Ophthalmology

Background: Changes in the choroidal blood flow (CBF) of patients with advanced retinitis pigmentosa (RP) complicated by a full-thickness macular hole (FTMH) were evaluated using laser speckle flowgraphy (LSFG) before and after vitreous surgery. Case: A 48-year-old Japanese female who was diagnosed with advanced RP presented with worsening and blurred vision in the left eye. Optical coherence tomography (OCT) at the initial visit revealed an FTMH in the left eye. The results of the LSFG demonstrated that the mean blur rate (MBR) in the macular lesion, which indicates macular blood flow, was lower in the affected eye (9.1 AU) (arbitrary units [AU]) than in the unaffected eye (10.6 AU). We performed a 25-gauge vitrectomy and ILM peeling using a hemi-inverted ILM flap technique in the left eye. Postoperative follow-up showed successful closure of the FTMH, with an increased in the macular blood flow to 11.8 AU and 13.2 AU at one and six months post-surgery, respectively along with improved visual acuity. Conclusion: Increased choroidal circulation was observed in a case of RP complicated by an FTMH after 25-gauge vitrectomy and the hemi-inverted ILM flap technique. The results suggest that a closer FTMH using the hemi-inverted ILM flap technique may improve macular blood flow and visual acuity. Keywords: Retinitis Pigmentosa; Macular Hole; Choroidal Blood Flow; Laser Speckle Flowgraphy; Hemi-Inverted ILM Technique; Vitrectomy

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