Clinical observation method for postoperative retina change of idiopathic macular pore patient

Abstract

The invention discloses an idiopathic macular pore patient postoperative retina change clinical observation method, which comprises the following steps: S1, collecting patient data, S2, carrying out an operation, S3, carrying out statistical analysis, S4, comparing data, and S5, concluding, and collecting 32 idiopathic macular pore patients to be included in the group for research. All patients are divided into two groups according to different operation modes, main observation indexes are central retina light sensitivity and peripheral retina light sensitivity, and other observation indexes comprise optimal corrected vision, retina superficial layer blood flow density, retina deep layer blood flow density and macular central depressed choroid thickness. The differences of the observation indexes between the two groups are compared, it is obtained through observation that after the idiopathic macular hole is treated through the vitreous body operation, the retina light sensitivity of the center of the macular part is obviously improved in the early stage of the operation, and improvement of the retina light sensitivity of the center of the macular part is closely related to changes of the retina blood flow density.

Description

Technical Field

[0001] The present invention relates to the technical field of clinical observation of retinal changes after surgery in patients with macular holes, and in particular to a method for clinical observation of retinal changes after surgery in patients with idiopathic macular holes. Background Art

[0002] A macular hole (MH) is a full-thickness defect of the retinal neuroepithelium at the fovea. Most MHs without obvious predisposing factors are called idiopathic macular holes (IMH). Gass's theory on the pathogenesis of idiopathic macular holes has been widely accepted, and vitrectomy for IMH has become the mainstream treatment method. With the continuous advancement of surgical equipment and surgical techniques, especially the application of the treatment technology of the inner limiting membrane of the macula during vitrectomy, the closure rate of IMH holes after surgery has also been continuously improved. While the closure rate of macular holes has increased, the changes in the visual function of patients after surgery have gradually attracted more attention. Studies have found that there are significant differences in the changes in the visual function of IMH patients after surgery. Most of the current related studies use the best corrected visual acuity as the main observation indicator, while there are few observations on the retinal light sensitivity of IMH patients after vitrectomy.

[0003] Microperimetry is more accurate than ordinary perimetry and is often used to examine and evaluate functional changes in the macula. The present invention mainly observes the changes in retinal photosensitivity in IMH patients after vitrectomy and explores the relationship between retinal photosensitivity and retinal blood flow density in the macular area by using microperimetry, optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). Summary of the invention

[0004] In view of the shortcomings of the prior art, the present invention provides a clinical observation method for retinal changes after surgery in patients with idiopathic macular hole, which solves the problem that there are obvious differences in the changes in visual function of IMH patients after surgery as mentioned in the background technology, and current related studies mostly use the best corrected visual acuity as the main observation indicator, while there are few observations on retinal photosensitivity after vitrectomy in IMH patients.

[0005] To achieve the above objectives, the present invention is implemented through the following technical solutions: a clinical observation method for postoperative retinal changes in patients with idiopathic macular hole, the steps of which include the following:

[0006] S1: Patient data were collected, and the data of IMH patients who underwent surgical treatment and whose macular holes were closed after surgery were excluded according to the standard. After exclusion according to the standard, 32 IMH patients who underwent surgical treatment and whose macular holes were closed after surgery were selected, and all patients were divided into 2 groups according to the surgical method;

[0007] Group A: underwent vitrectomy combined with internal limiting membrane tamponade;

[0008] Group B: underwent vitrectomy combined with internal limiting membrane flip-over surgery;

[0009] S2: Surgery was performed using the Alcon 23G microcannula system. Conventional three-incision vitrectomy was performed. Most of the vitreous and its posterior skin were removed during the operation. 0.5mg / mL ICG 0.2-0.4mL was injected into the vitreous cavity and aspirated after 15s. The internal limiting membrane was peeled off with intraocular microtweezers within a range of 4PD in diameter centered on the center of the macular hole.

[0010] In the patients of group A in S1, the internal limiting membrane of the macular hole was preserved (the width of the retained internal limiting membrane was about 1 / 2 of the diameter of the macular hole) and filled into the macular hole. Antibiotics and glucocorticoid eye drops were routinely used in the eyes after surgery.

[0011] In the patients of group B in S1, the internal limiting membrane above the edge of the macular hole was retained during the operation (the width of the retained internal limiting membrane was about 1.5 times the diameter of the macular hole) and a single layer was flipped over to cover the surface of the macular hole. After the operation, the vitreous cavity was filled with air. After the operation, the patients were in the prone position and antibiotics and glucocorticoid eye drops were routinely applied to the eyes.

[0012] S3: Statistical analysis. Statistical analysis was performed using STATA 12.1 data analysis software. Data were expressed as mean ± standard deviation. The differences among the three groups were analyzed using variance analysis. The differences between the two groups were analyzed using independent sample T test. Pearson correlation analysis was used to test the correlation between the variables. P < 0.05 was considered statistically significant.

[0013] S4: Comparison of data, including preoperative and postoperative baseline conditions, central retinal sensitivity, peripheral retinal sensitivity, superficial retinal blood flow density, deep retinal blood flow density, and subfoveal choroidal thickness of group A patients, and comparison of the correlation between retinal light sensitivity and retinal blood flow density and subfoveal choroidal thickness between group A and group B patients;

[0014] S5: Conclusion: We observed the changes in central retinal light sensitivity and peripheral retinal light sensitivity before and 1 month, 3 months, and 6 months after surgery in patients with idiopathic macular holes who received two surgical methods (vitrectomy combined with internal limiting membrane tamponade and vitrectomy combined with internal limiting membrane flip coverage), and observed other related indicators at the same time. The results showed that there were no significant differences in the observed indicators between the two groups of patients, suggesting that the difference in the effects of vitrectomy combined with internal limiting membrane tamponade and vitrectomy combined with internal limiting membrane flip coverage on IMH functional indicators is small. The main focus of preoperative selection of surgical methods should still be which surgical method is more conducive to the closure of macular holes.

[0015] Preferably, the exclusion criteria for collecting patient data in S1 are:

[0016] a. Patients with high myopia;

[0017] b. Patients with macular holes caused by trauma;

[0018] c. Those who have received any intraocular surgery within 6 months;

[0019] d. Other diseases that may affect retinal function, such as glaucoma, age-related macular degeneration, retinal vein occlusion, diabetic retinopathy, significant opacity of the refractive media, etc.;

[0020] e. Macular hole not closed after surgery.

[0021] Preferably, S4 also includes observation of the visual acuity of patients in groups A and B, and the observation shows that the best corrected visual acuity of all patients is significantly improved after surgery; the central retinal light sensitivity of patients in groups A and B is significantly improved at 1 month and 3 months after surgery, but no further improvement is found at 6 months after surgery.

[0022] Preferably, the blood flow density of the superficial and deep layers of the retina in the S4 increased significantly 1 month after surgery compared with that before surgery, but no significant changes were observed 3 and 6 months after surgery; the change in the choroidal thickness under the fovea was similar to the retinal blood flow density, with a significant increase in thickness only 1 month after surgery, and no further changes were found in subsequent observations.

[0023] Preferably, the correlation analysis in S4 shows that there is a significant correlation between the changes in postoperative central retinal light sensitivity in both groups A and B and the changes in superficial and deep retinal blood flow density, but no similar correlation was found between the changes in peripheral retinal light sensitivity and the changes in retinal blood flow density; at the same time, the analysis of the correlation between changes in central and peripheral retinal light sensitivity and changes in subfoveal choroidal thickness also found no significant correlation.

[0024] Preferably, the S2 also includes a preoperative inspection of the equipment, and the OCT and OCTA examinations are performed using an OCT and fundus color photography integrated device (Topcon DRIOCT Triton), and the examinations are completed by the same physician;

[0025] The OCT examination adopts the macular mode, with the macula as the center, the scanning range is 7mm×7mm, the scanning resolution is 512×128, the choroidal thickness under the fovea is measured, and the measurement is repeated 3 times to obtain the average value;

[0026] The OCTA imaging uses a 6 mm × 6 mm mode to scan the macula, and uses built-in software to identify and segment the superficial retina (inner limiting membrane to inner plexiform layer) and deep retina (inner plexiform layer to outer plexiform layer), and calculate blood flow density;

[0027] Retinal light sensitivity was tested using a MAIA microperimeter (Center Vue, maia-1, Italy) to measure retinal light sensitivity within 100 degrees of the fixation point, with 0°-5° as the central retinal light sensitivity and 5°-10° as the peripheral retinal light sensitivity.

[0028] Preferably, the observation time points are before surgery, 1 month, 3 months and 6 months after surgery, and the main observation indicators are central retinal light sensitivity (0°-5° range) and peripheral retinal light sensitivity (5°-10° range).

[0029] Preferably, other indicators are observed, including: best corrected visual acuity (LogMAR), superficial retinal blood flow density, deep retinal blood flow density, and subfoveal choroidal thickness; the differences in each observation indicator between the two groups are compared, and the correlation between retinal light sensitivity and retinal blood flow density and choroidal thickness is analyzed.

[0030] The present invention provides a method for clinical observation of retinal changes after surgery in patients with idiopathic macular hole. It has the following beneficial effects:

[0031] Methods: A total of 32 patients with idiopathic macular holes were enrolled in this study. All patients were divided into two groups according to the different surgical methods: patients in group A received vitrectomy combined with internal limiting membrane tamponade; patients in group B received vitrectomy combined with internal limiting membrane flipping and covering surgery. The main observation indicators were central retinal light sensitivity (, peripheral retinal light sensitivity, and other observation indicators included: best corrected visual acuity, superficial retinal blood flow density, deep retinal blood flow density, and subfoveal choroidal thickness. The differences in the observation indicators between the two groups were compared, and the correlation between retinal light sensitivity and retinal blood flow density and choroidal thickness was analyzed.

[0032] Through observation, it was found that after vitrectomy for idiopathic macular hole, the central retinal light sensitivity of the macula was significantly improved in the early postoperative period, and the improvement of the central retinal light sensitivity of the macula was closely related to the change of retinal blood flow density. BRIEF DESCRIPTION OF THE DRAWINGS

[0033] Figure 1 It is a schematic diagram of the process of the present invention;

[0034] Figure 2 This is a schematic diagram of BCVA changes in the present invention;

[0035] Figure 3 This is a schematic diagram of the change in central retinal sensitivity (dB) of the present invention;

[0036] Figure 4 Schematic diagram of peripheral retinal sensitivity (dB) of the present invention;

[0037] Figure 5 This is a schematic diagram of the change of superficial retinal blood flow density (%) of the present invention;

[0038] Figure 6 This is a schematic diagram of the change of the deep retinal blood flow density (%) of the present invention;

[0039] Figure 7 Schematic diagram of the change of choroidal thickness (um) under the fovea of ​​the present invention. DETAILED DESCRIPTION

[0040] The following will be combined with the drawings in the embodiments of the present invention to clearly and completely describe the technical solutions in the embodiments of the present invention. Obviously, the described embodiments are only part of the embodiments of the present invention, not all of the embodiments. Based on the embodiments of the present invention, all other embodiments obtained by ordinary technicians in this field without creative work are within the scope of protection of the present invention.

[0041] This study collected data from 32 patients (32 eyes), including 12 males (12 eyes) and 20 females (20 eyes), aged 43-69 years old (average age 55.64±7.14 years old), disease course 1-7 months (average 3.25±1.46 months), and macular hole diameter 375-858um (average 561.37±75.84um).

[0042] Group A: 15 cases (15 eyes), including 6 males (6 eyes) and 10 females (10 eyes), with an average age of 55.78±6.23 years, an average disease course of 3.37±2.11 months, and an average macular hole diameter of 566.45±62.89um;

[0043] Group B: 15 cases (15 eyes), including 6 males (6 eyes) and 10 females (10 eyes), with an average age of 54.56±4.31 years, an average disease course of 3.14±1.59 months, and an average macular hole diameter of 559.37±59.28um. There was no statistical difference in the baseline conditions between the two groups of patients (P>0.05).

[0044] Embodiment 1:

[0045] The BCVA of group A before and after surgery at each time point were: 1.13±0.19, 0.59±0.23, 0.44±0.31, 0.49±0.22, and the intra-group differences were statistically significant (P<0.001); the BCVA of group B before and after surgery at each time point were: 1.09±0.08, 0.58±0.21, 0.39±0.28, 0.46±0.18, and the intra-group differences were statistically significant (P<0.001). However, no significant statistical difference was found in the BCVA differences between the two groups at each observation time point ( Figure 2 , Table 1)

[0046] Table 1 Changes in BCVA (LogMAR)

[0047]

[0048] Embodiment 2:

[0049] The central retinal sensitivity of group A before and after surgery at each time point was 9.24±2.67, 14.65±3.78, 16.89±5.27, 17.22±3.77, and the difference within the group was statistically significant (P<0.001); the central retinal sensitivity of group B before and after surgery at each time point was 9.91±3.11, 14.19±4.59, 17.66±4.35, 17.67±3.79, and the difference within the group was statistically significant (P<0.001). No significant difference was found in the central retinal sensitivity between the two groups of patients at different time points ( Figure 3 , Table 2).

[0050] Table 2 Changes in central retinal sensitivity (dB)

[0051]

[0052] Embodiment 3:

[0053] The peripheral retinal sensitivity of group A before and after surgery at each time point was 20.14±3.23, 20.41±3.15, 21.61±4.62, 21.95±2.37, and no significant difference was found within the group (P=0.747); the peripheral retinal sensitivity of group B before and after surgery at each time point was 19.66±2.65, 21.54±3.46, 21.81±3.92, 20.99±3.71, and no significant difference was found within the group (P=0.894). No significant difference was found in the central retinal sensitivity between the two groups at different time points ( Figure 4 , Table 3)

[0054] Table 3 Peripheral retinal sensitivity (dB)

[0055]

[0056] Embodiment 4:

[0057] The superficial retinal blood flow density of group A before and after surgery at each time point was 60.23±9.87, 72.65±11.25, 70.64±10.36, 69.76±8.95, and the intra-group difference was significant (P=0.027); the superficial retinal blood flow density of group B before and after surgery at each time point was 62.19±7.58, 74.16±5.99, 74.33±6.74, 70.16±6.15, and the intra-group difference was also significant (P=0.031). No significant difference was found in the superficial retinal blood flow density between the two groups of patients at different time points ( Figure 5 , Table 4) Table 4 Retinal superficial blood flow density (%)

[0058]

[0059] Embodiment 5:

[0060] The deep retinal blood flow density at each time point before and after surgery in group A was 63.02±7.33, 69.11±3.68, 70.22±1.24, 68.24±4.62, respectively, with significant intra-group differences (P=0.018); the deep retinal blood flow density at each time point before and after surgery in group B was 61.66±5.11, 70.43±2.17, 71.54±3.74, 70.87±1.64, respectively, with significant intra-group differences (P=0.041). However, there was no significant difference in the deep retinal blood flow density at each time point between the two groups ( Figure 6 , Table 5)

[0061] Table 5 Changes in deep retinal blood flow density (%)

[0062]

[0063] Embodiment 6:

[0064] The subfoveal choroidal thickness of group A before and after surgery at each time point was 212.37±17.65, 234.81±20.18, 238.58±18.42, 236.77±14.62, and the intra-group changes were significant (P=0.038); the subfoveal choroidal thickness of group B before and after surgery at each time point was 217.65±11.69, 238.07±12.23, 237.91±13.62, 239.63±14.15, and the intra-group changes were also significant (P=0.037). There was no significant difference in subfoveal choroidal thickness at each time point between the two groups ( Figure 7 , Table 6)

[0065] Table 6 Changes in subfoveal choroidal thickness (um)

[0066]

[0067] Embodiment 7:

[0068] In group A, the central retinal light sensitivity was significantly correlated with the superficial retinal blood flow density and the deep retinal blood flow density (r = -0.478, P = 0.039; r = -0.568, P = 0.024), but not significantly correlated with the subfoveal choroidal thickness (r = -0.113, P = 0.687). However, the peripheral retinal light sensitivity was not significantly correlated with the superficial retinal blood flow density, the deep retinal blood flow density, and the subfoveal choroidal thickness (Table 7);

[0069] The analysis results of group B were similar to those of group A. The central retinal light sensitivity was significantly correlated with the superficial retinal blood flow density and the deep retinal blood flow density (r = -0.414, P = 0.028; r = -0.668, P = 0.042), but not significantly correlated with the subfoveal choroidal thickness (r = 0.034, P = 0.753). There was no significant correlation between the peripheral retinal light sensitivity and the superficial retinal blood flow density, the deep retinal blood flow density, and the subfoveal choroidal thickness in group B (Table 7);

[0070]

[0071] For patients with idiopathic macular holes, no matter what surgical method is used, the primary goal is still to close the macular hole. During the healing process of the patient's macular hole, the patient's central retinal light sensitivity gradually improves while the patient's vision improves. The observation results of this protocol show that the improvement of retinal light sensitivity in the central part of the macula is related to the change of retinal blood flow density, but the correlation with the change of choroidal thickness is not obvious, which may indicate that the improvement of retinal light sensitivity in the central part of the macula is more dependent on the improvement of retinal blood flow density. The obvious increase in superficial and deep retinal blood flow density at 1 month after surgery may indicate that the early stage of macular hole healing is the key period for the improvement of patients' visual function. In subsequent observations, the retinal blood flow density did not continue to increase. The possible reason for this protocol analysis is that the macular hole was completely closed at 1 month after surgery, and the retinal blood vessels and retinal blood flow tended to stabilize while the morphology of the macular area tended to stabilize. Therefore, no obvious and continuous increase in retinal blood flow could be observed at 3 months and 6 months after surgery. The central retinal light sensitivity still improved to a certain extent 3 months after surgery. The reason may be that the retinal microvascular blood flow still had a certain degree of relief and improvement at this time, which helped to further improve the light sensitivity of the central part of the macula. However, this subtle change in blood flow could not be recognized by the OCTA device and could not be imaged and displayed on the image. Therefore, after data analysis, the results showed that the central retinal light sensitivity continued to improve at 1 month and 3 months after surgery, while the retinal blood flow density was only observed to be significantly improved at 1 month after surgery. The reason for the increase in retinal blood flow density in the macula may be that the peripheral retinal blood vessels also migrated to the fovea during the healing process of the macular hole, thereby improving the blood flow density in this area. This can also explain the lack of obvious correlation between changes in peripheral retinal light sensitivity and changes in retinal blood flow density.

[0072] In summary, it is concluded that the central retinal light sensitivity of the macula is significantly improved in the early postoperative period after vitrectomy for idiopathic macular hole, and the improvement of central retinal light sensitivity of the macula is closely related to the change of retinal blood flow density.

[0073] The above shows and describes the basic principles and main features of the present invention and the advantages of the present invention. It is obvious to those skilled in the art that the present invention is not limited to the details of the above exemplary embodiments, and the present invention can be implemented in other specific forms without departing from the spirit or basic features of the present invention. Therefore, no matter from which point of view, the embodiments should be regarded as exemplary and non-restrictive. The scope of the present invention is defined by the attached claims rather than the above description, and it is intended that all changes falling within the meaning and scope of the equivalent elements of the claims are included in the present invention. Any figure mark in the claims should not be regarded as limiting the claims involved.

[0074] In addition, it should be understood that although the present specification is described according to implementation modes, not every implementation mode contains only one independent technical solution. This description of the specification is only for the sake of clarity. Those skilled in the art should regard the specification as a whole. The technical solutions in each embodiment may also be appropriately combined to form other implementation modes that can be understood by those skilled in the art.

Claims

1. A clinical observation method for postoperative retinal changes in patients with idiopathic macular hole, characterized by: The steps include: S1: Patient data were collected, and the data of IMH patients who underwent surgical treatment and whose macular holes were closed after surgery were excluded according to the standard. After exclusion according to the standard, 32 IMH patients who underwent surgical treatment and whose macular holes were closed after surgery were selected, and all patients were divided into 2 groups according to the surgical method; Group A: underwent vitrectomy combined with internal limiting membrane tamponade; Group B: underwent vitrectomy combined with internal limiting membrane flip-over surgery; S2: Surgery was performed using the Alcon 23G microcannula system. Conventional three-incision vitrectomy was performed. Most of the vitreous and its posterior skin were removed during the operation. 0.5mg / mL ICG 0.2-0.4mL was injected into the vitreous cavity and aspirated after 15s. The internal limiting membrane was peeled off with intraocular microtweezers within a range of 4PD in diameter centered on the center of the macular hole. In the patients of group A in S1, the internal limiting membrane of the macular hole was preserved (the width of the retained internal limiting membrane was about 1 / 2 of the diameter of the macular hole) and filled into the macular hole. Antibiotics and glucocorticoid eye drops were routinely used in the eyes after surgery. In the patients of group B in S1, the internal limiting membrane above the edge of the macular hole was retained during the operation (the width of the retained internal limiting membrane was about 1.5 times the diameter of the macular hole) and a single layer was flipped over to cover the surface of the macular hole. After the operation, the vitreous cavity was filled with air. After the operation, the patients were in the prone position and antibiotics and glucocorticoid eye drops were routinely applied to the eyes. S3: Statistical analysis. Statistical analysis was performed using STATA 12.1 data analysis software. Data were expressed as mean ± standard deviation. The differences among the three groups were analyzed using variance analysis. The differences between the two groups were analyzed using independent sample T test. Pearson correlation analysis was used to test the correlation between the variables. P < 0.05 was considered statistically significant. S4: Comparison of data, including preoperative and postoperative baseline conditions, central retinal sensitivity, peripheral retinal sensitivity, superficial retinal blood flow density, deep retinal blood flow density, and subfoveal choroidal thickness of group A patients, and comparison of the correlation between retinal light sensitivity and retinal blood flow density and subfoveal choroidal thickness between group A and group B patients; S5: Conclusion: We observed the changes in central retinal light sensitivity and peripheral retinal light sensitivity before and 1 month, 3 months, and 6 months after surgery in patients with idiopathic macular holes who received two surgical methods (vitrectomy combined with internal limiting membrane tamponade and vitrectomy combined with internal limiting membrane flip coverage), and observed other related indicators at the same time. The results showed that there were no significant differences in the observed indicators between the two groups of patients, suggesting that the difference in the effects of vitrectomy combined with internal limiting membrane tamponade and vitrectomy combined with internal limiting membrane flip coverage on IMH functional indicators is small. The main focus of preoperative selection of surgical methods should still be which surgical method is more conducive to the closure of macular holes.

2. The method for clinical observation of retinal changes after surgery in patients with idiopathic macular hole according to claim 1, characterized in that: The exclusion criteria for collecting patient data in S1 are: a. Patients with high myopia; b. Patients with macular holes caused by trauma; c. Those who have received any intraocular surgery within 6 months; d. Other diseases that may affect retinal function, such as glaucoma, age-related macular degeneration, retinal vein occlusion, diabetic retinopathy, significant turbidity of the refractive media, etc.; e. Macular hole not closed after surgery.

3. The method for clinical observation of retinal changes after surgery in patients with idiopathic macular hole according to claim 1, characterized in that: S4 also includes observations on the visual acuity of patients in Groups A and B, which showed that the best corrected visual acuity of all patients was significantly improved after surgery; the central retinal light sensitivity of patients in Groups A and B was significantly improved at 1 month and 3 months after surgery, but no further improvement was found at 6 months after surgery.

4. The method for clinical observation of retinal changes after surgery in patients with idiopathic macular hole according to claim 1, characterized in that: The blood flow density of the superficial and deep layers of the retina in S4 increased significantly one month after surgery compared with before surgery, but no significant changes were observed at three and six months after surgery; the changes in the choroidal thickness under the fovea were similar to the retinal blood flow density, with a significant increase in thickness only one month after surgery, and no further changes were found in subsequent observations.

5. The method for clinical observation of retinal changes after surgery in patients with idiopathic macular hole according to claim 1, characterized in that: The correlation analysis in S4 showed that there was a significant correlation between the changes in postoperative central retinal light sensitivity and the changes in superficial and deep retinal blood flow density in both groups A and B, but no similar correlation was found between the changes in peripheral retinal light sensitivity and the changes in retinal blood flow density; at the same time, the analysis of the correlation between the changes in central and peripheral retinal light sensitivity and the changes in subfoveal choroidal thickness also did not find a significant correlation.

6. The method for clinical observation of retinal changes after surgery in patients with idiopathic macular hole according to claim 1, characterized in that: The S2 also includes a preoperative inspection of the equipment. OCT and OCTA examinations are performed using an integrated OCT and fundus color photography device (Topcon DRIOCT Triton), and the examinations are completed by the same physician. The OCT examination adopts the macular mode, with the macula as the center, the scanning range is 7mm×7mm, the scanning resolution is 512×128, the choroidal thickness under the fovea is measured, and the measurement is repeated 3 times to obtain the average value; The OCTA imaging uses a 6 mm × 6 mm mode to scan the macula, and uses built-in software to identify and segment the superficial retina (inner limiting membrane to inner plexiform layer) and deep retina (inner plexiform layer to outer plexiform layer), and calculate blood flow density; Retinal light sensitivity was tested using a MAIA microperimeter (Center Vue, maia-1, Italy) to measure retinal light sensitivity within 100 degrees of the fixation point, with 0°-5° as the central retinal light sensitivity and 5°-10° as the peripheral retinal light sensitivity.

7. The method for clinical observation of retinal changes after surgery in patients with idiopathic macular hole according to claim 3, characterized in that: The observation time points were before surgery, 1 month, 3 months, and 6 months after surgery, and the main observation indicators were central retinal light sensitivity (0°-5° range) and peripheral retinal light sensitivity (5°–10° range).

8. The method for clinical observation of retinal changes after surgery in patients with idiopathic macular hole according to claim 3, characterized in that: Other indicators were also observed, including best corrected visual acuity (LogMAR), superficial retinal blood flow density, deep retinal blood flow density, and subfoveal choroidal thickness; the differences in each observation indicator between the two groups were compared, and the correlation between retinal light sensitivity and retinal blood flow density and choroidal thickness was analyzed.

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