The current investigation examined the significance of macular pigment optical density (MPOD) in individuals with full-thickness macular hole (FTMH) compared with healthy volunteers. It also aimed to monitor changes in MPOD following surgery and to determine any potential links between these changes and final visual performance. This prospective, cross-sectional, comparative analysis included 16 eyes of patients with FTMH who achieved complete anatomical closure after pars plana vitrectomy with the inverted ILM flap procedure. All eyes received a thorough eye examination consisting of best-corrected visual acuity (BCVA) testing, intraocular pressure measurement, anterior segment assessment, fundus inspection, and detailed macular imaging via Enhanced Depth Imaging Optical Coherence Tomography (EDI-OCT, Spectralis, Heidelberg Engineering Inc., Heidelberg, Germany). Macular pigment optical density (MPOD) was assessed using one-wavelength reflectometry (Visucam 200, Zeiss Meditec, Jena, Germany). Evaluations were performed before surgery and at 1, 3, and 6 months after surgery to assess changes over time and investigate associations between MPOD and visual outcomes. At baseline, clear differences existed between the FTMH and control groups in BCVA, mean MPOD, maximum MPOD, and MPOD volume (P < 0.05). After the procedure, BCVA showed a notable improvement (P = 0.0011), while MPOD volume increased significantly by the 6-month follow-up (P = 0.01). A robust positive relationship was detected between the extent of BCVA improvement and the growth in MPOD volume (r = 0.739; P = 0.002). Overall, incorporating MPOD measurement into the postoperative care of FTMH cases may provide valuable supplementary information on photoreceptor condition and macular metabolic processes, which may be linked to the degree of visual restoration. More extensive, long-term research is warranted to better understand its connections with various clinical aspects, including metamorphopsia and fine structural details observed on OCT.
