Correlation of photoreceptor disruption at the idiopathic macular hole border with ocular blood flow density and visual prognosis

Purpose To evaluate the association of photoreceptor outer segment (OS) destruction at the borders of idiopathic macular hole (IMH) with retinal and choroidal vascular density, as well as the impact of photoreceptor damage on preoperative and postoperative retinal function.Methods Forty-two eyes of 42 patients diagnosed with IMH underwent a full ophthalmologic examination preoperatively and at 1, 3, and 6 months postoperatively, including swept-source optical coherence tomography (SS-OCT), OCTA, best-corrected visual acuity (BCVA), microperimetry and multifocal electroretinography (mfERG).Results After adjusting for confounders, multivariate regression analysis revealed that bumpy borders were negatively correlated with the foveal choriocapillaris density (P = 0.006). Preoperatively, eyes with bumpy borders demonstrated significantly poorer BCVA (P Conclusions Bumpy IMH border morphology is associated with reduced preoperative foveal choriocapillaris density and independently predicts poorer postoperative visual recovery, thereby providing a crucial foundation for elucidating the mechanisms underlying photoreceptor damage in IMH.