Case Series of Full-thickness Macular Hole Associated with Posterior Pole Retinal Detachment: Surgical Insights and Postclosure Optical Coherence Tomography Angiography Analysis

Abstract

Full-thickness macular hole associated with posterior pole retinal detachment (PPRD) is a vision-threatening condition caused by complex vitreomacular traction. We report a case series of three patients managed surgically and share key surgical insights. All patients underwent detailed fundus evaluation and optical coherence tomography (OCT), which confirmed the presence of full-thickness macular hole with PPRD. Surgical management included pars plana vitrectomy with posterior vitreous detachment induction, internal limiting membrane peeling, and gas tamponade. Complete posterior pole reattachment with macular hole closure was achieved in all eyes. Postoperative OCT confirmed anatomical restoration. OCT angiography (OCTA) revealed a consistent reduction in superficial capillary plexus vascular density in operated eyes compared with fellow eyes, indicating persistent macular microvascular compromise. These findings suggest that OCTA-based vascular assessment provides valuable insight into postoperative remodeling of foveal avascular zone microvasculature and may provide insights into the variability between anatomical success and functional recovery; however, larger studies are required to establish this association. Visual recovery varied according to preoperative macular status and chronicity of detachment.