频域OCT扫描观察特发性黄斑裂孔的脉络膜厚度

Spectral-domain optical coherence tomography findings of choroidal thickness in eyes with idiopathic macular holes

目的探讨特发性黄斑裂孔（IMH）患眼手术前后黄斑中心凹脉络膜厚度（SFCT），及其与术前、术后最佳矫正视力的相关性。方法临床病例对照研究。对2013年1月至2014年1月在潍坊医学院附属医院眼科中心就诊的单眼IMH患者共24例（24只眼），并纳入24名性别、年龄相匹配的正常对照者，采用频域光学相干断层扫描技术测量IMH患眼与正常对照眼SFCT及中心凹鼻侧、顾侧、上方和下方1mm处共5个位点的脉络膜厚度。并分析患眼术前、术后最佳矫正视力与术前SFCT的相关性。结果IMH患眼组、IMH患者对侧健眼、正常对照组的SFCT均值分别为（190．634±28．33）、（221．524±24．63）、（254．21±22．99）μm，方差分析显示三组间所有位点的脉络膜厚度差异均有统计学意义[SFCT（F=4．08，P=0．032）、NCTlmm（F=3．97，P=0．041）、TCTlmm（F=4．21，P=0．034）、SCTlmm（F=4．03，P=0．027）、ICT1mm（F=4．57，P=0．046）]。进一步行SNK检验，IMH患眼各位点的脉络膜厚度值均较正常对照组显著降低，差异有统计学意义，[SFCT（q=3．68，P=0．037）、NCT1mm（q=4．04，P=0．021）、TCT1mm（q=4．12，P=0．041）、SCT1mm（q=3．86，P=0．025），ICT1mm（q=4．21，P=0．029）]。IMH对侧健眼与正常对照组仅SFCT差异有统计学意义（q=4．02，P=0．033）。术前SFCT与术前、术后最佳矫正视力差异无统计学意义（r=0．306，P=0．073；，=0．268，P=0．078）。结论IMH患者患眼的脉络膜厚度明显变薄，提示脉络膜厚度变薄与IMH的发生可能存在一定关系，而与患者最佳矫正视力无相关性。

Objective To observe the choroidal thickness in eyes with idiopathic macular holes （IMH）, unaffected fellow eyes and compare with the normal eyes, and find the correlation between the subfoveal area choroidal thickness and the visual acuity. Methods Twenty-four unilateral IMH patients and 24 age- and sex-matched healthy controls in this research. The choroidal thickness was measured in the subfoveal area and lmm away from the fovea in the nasal, temporal, superior and inferior regions. The IMH eyes＇ preoperative best correct visual acuity with the postoperative best correct visual acuity was compared. Results The average subfoveal choroidal thickness （SFCT） of IMH eyes was （190.63±28.33）μm, the unaffected fellow eyes was （221.52±24.63）μm, the normal eyes was （254.21±22.99）μm. The SFCT showed significant differences among three groups, SFCT （F =4.08, P =0.032）, NCTlmm （F =3.97, P =0.041）, TCTImm （F =4.21, P =0.034）, SCTlmm （F = 4.03, P =0.027）, ICTlmm （F =4.57, P =0.046）. The choroidal thickness of all measured regions in IMH eyes had a significantly reduce than the normal eyes, SFCT （q =3.68, P=0.037）, NCTlmm （q = 4.04, P =0.021）, TCTlmm （q =4.12, P =0.041）, SCTlmm （q =3.86, P =0.025）, ICTlmm （q =4.21,P =0.029）. There was a significant difference in SFCT between the unaffected eyes and the normal eyes, （q =4,02, P =0.033）. There was no correlation between the SFCT with the preoperative and postoperative best correct visual acuity （r =0.306, P =0.073）, （r =0.268, P =0.078）. Conclusions The choroidal thickness of IMH patients is thinner than the normal eyes, but has nothing to do with the best correct visual acuity.