Chen M F, Zheng C C, Liu Y, Chen F, Xu D
Eye Hospital of Wenzhou Medical University, National Clinical Research Center for Ocular Diseases, Wenzhou 325027, China.
Zhonghua Yan Ke Za Zhi. 2022 Jun 11;58(6):412-419. doi: 10.3760/cma.j.cn112142-20210918-00436.
To investigate the choroidal blood flow and visual function in idiopathic macular hole. In this prospective study, fundus structure and visual function in 22 eyes with macular hole and their fellow eyes and 16 normal eyes were assessed. The best corrected visual acuity and retinal sensitivity were detected by the EDTRS visual chart and MP1. The choroidal blood flow was observed by optical coherence tomography angiography. The choriocapillary blood flow density was measured using MatLab. The thickness of the choroid and the aperture size of macular hole were measured using enhanced depth imaging mode of Heidelberg optical coherence tomography. The best corrected visual acuity and retinal sensitivity of macular hole eyes [1.02±0.20 and (13.03±2.91) dB] were significantly lower than fellow eyes [0.15±0.11, =17.019, <0.001 and (17.25±2.03) dB, =-4.085, <0.001] and normal eyes [0.04±0.05, =21.736, =0.001 and (16.63±2.89) dB, =-3.134, =0.004]. The blood flow area of choroidal capillaries in macular hole eyes [(1.33±0.29) mm] was significantly lower than fellow eyes [(1.98±0.13) mm; =-9.424, <0.001] and normal eyes [(1.93±0.12) mm; =-8.707, <0.001]. The paracentral blood vessel density of the choroid capillary layer in macular hole eyes (48.91%±10.12%) was significantly lower than fellow eyes (58.27%±6.18%; =-3.502, =0.001) and normal eyes (55.20%±2.12%; =-2.830, =0.020). The subfoveal choroidal thickness of macular hole eyes [(188±21) μm] was significantly lower than fellow eyes [(217±36) μm; =-3.672, =0.002] and normal eyes [(229±25) μm; =-3.304, <0.001]. The basic diameter of macular hole eyes was correlated with the blood vessel density (=-0.584, =0.004), the subfoveal choroidal thickness (=-0.511, =0.015) and the retinal sensitivity (=-0.432, =0.044). The retinal sensitivity was correlated with the blood vessel density (=0.450, =0.035) and the subfoveal choroidal thickness (=0.429, =0.046). The retinal sensitivity and fundus blood perfusion of idiopathic macular hole was decreased, and the thickness of paracentral choroid in the contralateral eye tended to become thinner. The reduced visual function in eyes with macular hole may be associated with the decreased choroidal thickness and worse blood flow of fundus microcirculation.
探讨特发性黄斑裂孔的脉络膜血流及视功能。在这项前瞻性研究中，对22只患有黄斑裂孔的眼睛及其对侧眼以及16只正常眼睛的眼底结构和视功能进行了评估。通过EDTRS视力表和MP1检测最佳矫正视力和视网膜敏感度。通过光学相干断层扫描血管造影观察脉络膜血流。使用MatLab测量脉络膜毛细血管血流密度。使用海德堡光学相干断层扫描的增强深度成像模式测量脉络膜厚度和黄斑裂孔的孔径大小。黄斑裂孔眼的最佳矫正视力和视网膜敏感度[1.02±0.20和(13.03±2.91)dB]显著低于对侧眼[0.15±0.11，t = 17.019，P < 0.001和(17.25±2.03)dB，t = -4.085，P < 0.001]以及正常眼[0.04±0.05，t = 21.736，P = 0.001和(16.63±2.89)dB，t = -3.134，P = 0.004]。黄斑裂孔眼的脉络膜毛细血管血流面积[(1.33±0.29)mm²]显著低于对侧眼[(1.98±0.13)mm²；t = -9.424，P < 0.001]和正常眼[(1.93±0.12)mm²；t = -8.707，P < 0.001]。黄斑裂孔眼的脉络膜毛细血管层旁中心血管密度(48.91%±10.12%)显著低于对侧眼(58.27%±6.18%；t = -3.502，P = 0.001)和正常眼(55.20%±2.12%；t = -2.830，P = 0.020)。黄斑裂孔眼的黄斑下脉络膜厚度[(188±21)μm]显著低于对侧眼[(217±36)μm；t = -3.672，P = 0.002]和正常眼[(229±25)μm；t = -3.304，P < 0.001]。黄斑裂孔眼的基础直径与血管密度(r = -0.584，P = 0.004)、黄斑下脉络膜厚度(r = -0.511，P = 0.015)和视网膜敏感度(r = -0.432，P = 0.044)相关。视网膜敏感度与血管密度(r = 0.450，P = 0.035)和黄斑下脉络膜厚度(r = 0.429，P = 0.046)相关。特发性黄斑裂孔的视网膜敏感度和眼底血流灌注降低，对侧眼旁中心脉络膜厚度有变薄趋势。黄斑裂孔眼视功能降低可能与脉络膜厚度降低及眼底微循环血流变差有关。
