目的：探讨玻璃体切除手术对特发性黄斑裂孔(IMH)黄斑区脉络膜血流的影响及脉络膜微结构变化在黄斑裂孔形成中的作用。

方法：选取2014-05/2015-12单眼IMH患者56例56眼纳入研究，所有患者均行三通道平坦部玻璃体切除+吲哚菁绿辅助内界膜剥除+12%C₃F₈气体填充术。晶状体混浊者联合超声乳化吸出+人工晶状体植入。术前及术后1、3、6mo行EDI SD-OCT检查，记录黄斑中心凹下及距中心凹上方、下方、鼻侧、颞侧各1、3mm处共9个位点的脉络膜厚度。

结果：术前黄斑中心凹下脉络膜厚度(SFCT)值为233.43±84.638μm，术后1、3、6mo SFCT分别为242.46±88.199，238.97±89.252，236.71±88.661μm，术后1mo与术前相比明显升高(P<0.05)。距中心凹下方3mm处的脉络膜厚度值(ICT_3mm)术前(170.89±57.040μm)与术后1、3、6mo(179.63±62.941、179.74±65.981、180.80±58.379μm)相比呈逐渐增高趋势，但各个测量时间点的ICT_3mm值两两比较无差异。 距中心凹下方1mm处的脉络膜厚度值(ICT_1mm)术前(207.37±67.502μm)与术后1、3、6mo(216.31±80.297、214.54±75.693、205.69±68.697μm)有差异(P<0.05)，术后6mo与术后1mo相比有差异(P<0.05)。

结论：脉络膜厚度降低可能是黄斑裂孔形成的原因，IMH患者术后脉络膜厚度值变化与位置有关，可能与术中填塞气体的压迫作用有关。

METHODS: Totally 56 eyes of 56 patients diagnosed with unilateral IMH were included(2014-05/2015-12). All patients received pars planar vitrectomy, indocyanine green assisted inner limiting membrane peeling combined with intraocular +12%C₃F₈ tamponade. Patients with cataract received phacoemulsification and intraocular lens implantation. Choroidal thicknesses were measured at 9 points before and at 1, 3 and 6mo after the surgery, namely the fovea, 1mm and, 3mm above, below, nasal and temporal to the fovea.

RESULTS: Preoperative SFCT value was 233.43±84.638μm, and at 1, 3, 6mo follow-up SFCT were 242.46±88.199μm, 238.97±89.252μm, and 236.71±88.661μm, respectively. SFCT at 1mo after surgery was significantly increased compared to preoperative thickness(P<0.05). 1, 3, and 6mo after the surgery the choroidal thickness at 3mm below the fovea(ICT_3mm)(179.63±62.941μm, 179.74±65.981μm, 180.80±58.379μm)gradually increased compared with those before the surgery(170.89±57.040μm). However, there was no significant difference between ICT_3mm values at each time point. 1, 3, and 6mo after the surgery the choroidal thickness at 1mm below the fovea(ICT_1mm)(216.31±80.297μm, 214.54±75.693μm, 205.69±68.697μm)compared with those before the surgery(207.37±67.502μm)have statistical significance. Compared 6mo after the surgery with 1mo after the surgery have statistical significance with ICT_1mm values at each time point(P<0.05).

CONCLUSION: SFCT of the study eyes showed a transient increase at 1mo follow up, then gradually returned to the base line. As the macular hole successfully closed, the choroidal thickness didn't not show difference compared with baseline, indicating that the decreasing in choroidal thickness is possibly the cause to the formation of the macular hole, not the results. IMH postoperative choroidal thickness values change by location, which may be due to the oppression by the injected gas in the macular hole surgery.