基于中央凹下脉络膜厚度预测特发性黄斑裂孔患者的解剖学预后

目的 探讨中央凹下脉络膜厚度(SFCT)是否可以作为特发性黄斑裂孔(IMH)患者解剖学预后的预测因素。方法 回顾性研究。选取2018年9月至2020年9月期间就诊于南昌大学第二附属医院眼科经EDI-SD-OCT确诊并施行超声乳化白内障吸除伴人工晶状体植入+玻璃体切割+ILM剥除及硅油填充术的IMH患者63例66眼纳入研究，术后随访3～6个月，根据末次随访时患眼裂孔愈合情况分为闭合组和非闭合组。利用频域OCT深度增强成像(EDI-SD-OCT)测量所有患眼的SFCT,记录患眼术前黄斑裂孔最小孔径、基底径，同时记录患者的术前临床资料。运用Spearman相关性分析SFCT与术前临床资料的相关关系，使用二元Logistic回归分析可能与术后裂孔闭合相关的因素。结果 术后随访3～6个月，闭合组56眼，非闭合组10眼，裂孔闭合率为84.8%。闭合组和非闭合组患眼的术前SFCT分别为(195.77±55.53)μm和(139.35±26.05)μm,差异有统计学意义(t=5.09,P=0.00)。闭合组患眼症状持续时间<6个月者所占比例较非闭合组高，差异有统计学意义(P<0.05)。S...

Prediction of anatomical prognosis of idiopathic macular holes based on the subfoveal choroid thickness

Objective　To investigate whether subfoveal choroidal thickness (SFCT) can be used as a predictor of anatomical prognosis of idiopathic macular holes (IMH).
Methods　Totally 63 patients (66 eyes) with IMH diagnosed by enhanced depth imaging spectral-domain optical coherence tomography (EDI-SD-OCT) in the Department of Ophthalmology of the Second Affiliated Hospital of Nanchang University from September 2018 to September 2020 were included in this retrospective study, and divided into the closed group and unclosed group according to the healing of macular holes at the last follow-up. All patients underwent phacoemulsification and intraocular lens implantation+vitrectomy+internal limiting membrane peeling+silicone oil filling. SFCT of all affected eyes was measured by EDI-SD-OCT, the preoperative minimum diameter and basal diameter of the macular holes were observed, and preoperative clinical data of the patients were recorded. Spearman correlation was used to analyze the correlation between SFCT and preoperative clinical data, and binary logistic regression was used to analyze the factors that might be related to postoperative macular hole closure.
Results　In the 3-6 months of follow-up, macular holes of 56 eyes were closed, and those of 10 eyes were unclosed, showing a closure rate of 84.8%. The preoperative SFCT of patients in the closed group and the unclosed group were (195.77±55.53)μm and (139.35±26.05)μm, respectively, and the differences were statistically significant (t=5.09, P=0.00). The proportion of patients with ocular symptoms <6 months in the closed group was higher than that in the unclosed group, and the difference was statistically significant (P<0.05). The Spearman correlation analysis showed that there was no significant difference between preoperative SFCT of IMH eyes and age, gender, eye side, axial length, minimum diameter and basal diameter of macular hole, symptom duration and preoperative best corrected visual acuity (all P>0.05). Binary logistic regression analysis showed that the macular hole closure after IMH surgery was significantly correlated with preoperative SFCT (OR=0.34, P=0.01), but was uncorrelated with the duration of symptoms (OR=0.21, P=0.21).
Conclusion　SFCT is an independent influencing factor of macular hole closure after IMH surgery and can be used as an index to predict the postoperative anatomical outcomes of IMH.