Sul Sabahattin, Gurelik Gökhan, Korkmaz Şafak, Ozsaygili Cemal
Department of Ophthalmology, Muğla Sıtkı Koçman University, 48000, Muğla, Turkey.
Department of Ophthalmology, Gazi University Medical School, Ankara, Turkey.
Int Ophthalmol. 2019 Nov;39(11):2595-2601. doi: 10.1007/s10792-019-01108-6. Epub 2019 May 7.
To determine the association between choroidal thickness (CT) and anatomic success in closed and open macular holes (MHs) following surgery.
One hundred and thirty-six eyes of 136 patients who underwent surgery due to primary MH were included in this study. Choroidal thickness was measured from various points (subfoveal, temporal, nasal, superior and inferior 1500 µm from the center of the fovea) in both eyes with MH and fellow eyes. We determined associations among the duration of symptoms, MH dimensions and CTs from various points with anatomic success and correlations between CT and MH dimensions and duration of symptoms.
Choroidal thickness was significantly lower in eyes with MH than fellow eyes in both open and closed MHs. Base diameter [p = 0.025, odds ratio (OR) = 0.428], minimum hole diameter (p = 0.030, OR = 0.211) and duration of symptoms [p = 0.034, OR = 0.443] were significantly associated with anatomic success. However, CTs from various points were not associated with anatomic success despite a significant preoperative subfoveal CT difference between open and closed MHs (198 ± 21 µm in open MHs and 230 ± 30 µm in closed MHs; p < 0.001). Preoperative subfoveal CT was moderately correlated with base diameter (r = - 0.505, p < 0.001), minimum hole diameter (r = - 0.518, p < 0.001) and duration of symptoms (r = - 0.510, p < 0.001).
Failed MHs were associated with larger hole dimensions (base diameter and minimum hole diameter) and longer duration of symptoms. Preoperative subfoveal CT was thinner in open MHs, but there was no association with anatomic success. Choroidal thinning may be linked to larger and chronic MHs.
确定脉络膜厚度（CT）与手术治疗闭合性和开放性黄斑裂孔（MH）的解剖学成功率之间的关联。
本研究纳入了136例因原发性MH接受手术的患者的136只眼。在患MH的双眼及对侧眼中，从多个点（黄斑中心凹下、颞侧、鼻侧、距黄斑中心1500 µm的上方和下方）测量脉络膜厚度。我们确定了症状持续时间、MH大小和各点CT与解剖学成功率之间的关联，以及CT与MH大小和症状持续时间之间的相关性。
在开放性和闭合性MH中，患MH的眼的脉络膜厚度均显著低于对侧眼。基底直径[p = 0.025，比值比（OR）= 0.428]、最小裂孔直径（p = 0.030，OR = 0.211）和症状持续时间[p = 0.034，OR = 0.443]与解剖学成功率显著相关。然而，尽管开放性和闭合性MH术前黄斑中心凹下CT存在显著差异（开放性MH为198±21 µm，闭合性MH为230±30 µm；p < 0.001），但各点CT与解剖学成功率无关。术前黄斑中心凹下CT与基底直径（r = -0.505，p < 0.001）、最小裂孔直径（r = -0.518，p < 0.001）和症状持续时间（r = -0.510，p < 0.001）中度相关。
未成功的MH与较大的裂孔尺寸（基底直径和最小裂孔直径）和较长的症状持续时间相关。开放性MH术前黄斑中心凹下CT较薄，但与解剖学成功率无关。脉络膜变薄可能与较大的慢性MH有关。
