Choroidal thickness in lamellar macular holes

Graefes Arch Clin Exp Ophthalmol. 2021 Mar;259(3):653-659. doi: 10.1007/s00417-020-04922-2. Epub 2020 Sep 18.

Abstract

Purpose: (1) To assess the thickness of the central choroid (BM-CSI) in swept-source optical coherence tomography (SS-OCT) examination of lamellar macular holes (LMHs). (2) To establish correlations between the thickness of the central choroid (BM-CSI) in the LHM and the parameters of best-corrected visual acuity and reading vision in patients with LMH.

Methods: This prospective case-control study assessed a group of 30 patients (30 eyes) with LMHs and a control group of 45 patients (90 eyes). The thickness of the central choroid (BM-CSI) was measured with an SS-OCT device. The average choroidal thickness in the fovea was defined as average thickness in the central area of 1000 μm in diameter, according to the Early Treatment Diabetic Retinopathy Study (ETDRS). The results were correlated with best-corrected visual acuity (BCVA), and reading vision.

Results: The average choroidal thickness in the study group (SG) with LMH was 160.34 μm (SD = 77.1), whereas in the control group (CG), it was 225.11 μm (SD = 93.8). The difference of 64.77 μm was statistically significant (p < 0.05). The BCVA was within the range between 0.7 (logMAR) and 0.1 (logMAR), with an average of 0.36 (logMAR) (SD = 0.23). Reading vision was within the range between - 0.2 (logMAR) and 0.3 (logMAR), with an average of 0.27 (logMAR) (SD = 0.12). A significant correlation between BCVA and the choroid (BM-CSI) was found. The correlation coefficient is average (r = 0.44) and positive. With better BCVA, a significantly thicker choroid (BM-CSI) can be observed. No significant correlation between BM-CSI and reading vision was found. The correlation coefficient value is minor (r = - 0.289), whereas lower values of BM-CSI can be observed with worse reading vision.

Conclusion: We suggest that the choroid may take part in the pathogenesis of LMH development. Its significant thinning may be responsible for the ischemic degenerative mechanism degenerating outer layers of retina, apart from tractional mechanism.

Keywords: Choroid; Choroidal thickness; Lamellar macular hole; Optical coherence tomography; Swept-source OCT.

MeSH terms

  • Case-Control Studies
  • Choroid
  • Humans
  • Prospective Studies
  • Retinal Perforations*
  • Tomography, Optical Coherence
  • Visual Acuity