State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China.
Ophthalmology. 2012 Nov;119(11):2328-33. doi: 10.1016/j.ophtha.2012.06.008. Epub 2012 Aug 11.
To compare the choroidal thickness in the macular area in eyes with an idiopathic macular hole (IMH) with that of unaffected fellow eyes and eyes of healthy controls.
A cross-sectional study.
Fifty patients with unilateral IMH and 50 healthy controls.
Enhanced depth imaging was obtained by spectral-domain optical coherence tomography in all patients and controls. Eyes were divided into 3 groups: 50 eyes in group A (affected eyes with IMH), 48 eyes in group B (unaffected fellow eyes), and 50 eyes in group C (right eyes of age- and sex-matched controls).
Two independent graders individually measured the choroidal thickness. Choroidal thickness was measured from the posterior edge of the retinal pigment epithelium to the choroid-scleral junction in the subfoveal area and 1 and 3 mm away from the fovea in the superior, inferior, nasal, and temporal regions. Apical and basal diameters of macular holes (MHs) were measured in eyes with IMH. Statistical analysis was conducted to compare mean choroidal thicknesses.
Choroidal thickness was significantly decreased in affected IMH eyes compared with unaffected fellow eyes in 48 patients (P = 0.005, paired t test). The mean subfoveal choroidal thickness (SFCT) was 206.82 ± 67.09 μm in group A, 228.34 ± 80.71 μm in group B, and 248.88 ± 63.10 μm in group C. The choroid was significantly thinner in group A (P = 0.002) than in group C. The SFCT in unaffected fellow eyes was lower than in controls, but without statistical significance (P = 0.177). The apical and basal size of the MH were not related to the underlying choroidal thickness (apical r=-0.267, P = 0.072; basal r = -0.259, P = 0.082).
Choroidal thickness was thinner in affected eyes with IMH and in fellow unaffected eyes. This may suggest a contributing role of the perfusion of the choroid in the pathogenesis of IMH. If these findings are confirmed, we suggest that the fellow eyes with thinner choroid may be prone to IMH and should be followed up frequently.
比较特发性黄斑裂孔（IMH）患眼与健眼及正常对照眼黄斑区脉络膜厚度。
横断面研究。
50 例单侧 IMH 患者和 50 例健康对照。
所有患者和对照者均行频域光学相干断层扫描增强深度成像。将眼分为 3 组：A 组（患眼）50 只眼，B 组（健眼）48 只眼，C 组（年龄和性别匹配的右眼对照）50 只眼。
2 名独立的评估者分别测量脉络膜厚度。在黄斑中心凹下、上、下、鼻、颞 1mm 和 3mm 处，从视网膜色素上皮后缘至脉络膜-巩膜交界处测量脉络膜厚度。对 IMH 眼中黄斑裂孔（MH）的顶、底直径进行测量。统计学分析比较平均脉络膜厚度。
48 例患者中，患眼 IMH 与健眼比较，脉络膜厚度显著变薄（P = 0.005，配对 t 检验）。A 组黄斑中心凹下脉络膜厚度（SFCT）平均为 206.82±67.09μm，B 组为 228.34±80.71μm，C 组为 248.88±63.10μm。A 组脉络膜厚度明显变薄（P = 0.002）。健眼 SFCT 低于对照组，但无统计学意义（P = 0.177）。MH 的顶、底大小与脉络膜厚度无相关性（顶径 r=-0.267，P = 0.072；底径 r=-0.259，P = 0.082）。
IMH 患眼和健眼脉络膜厚度变薄。这可能提示脉络膜灌注在 IMH 发病机制中起作用。如果这些发现得到证实，我们建议脉络膜较薄的对侧眼可能更容易发生 IMH，应密切随访。
