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Spielt die Aderhautdicke beim idiopathischen Makulaforamen eine Rolle?

Is choroidal thickness of importance in idiopathic macular hole?

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Zusammenfassung

Hintergrund

Es gibt Hinweise, dass die Aderhaut (AH) bei der Pathogenese des idiopathischen Makulaforamens (MF) eine Rolle spielen kann. Kürzlich wurde berichtet, dass die AH-Dicke bei MF sowohl am betroffenen Auge wie auch am nicht betroffenen Partnerauge signifikant dünner ist als bei alterskorrelierten Kontrollaugen.

Methode

Bei 12 Patienten mit MF wurde die subfoveale AH-Dicke mit dem „Enhanced Depth Imaging“ (EDI)-Modus des Spectralis vermessen. Bei 2 dieser Patienten bestand ein beidseitiges MF. Die Messungen erfolgten präoperativ sowie 8 Wochen und 6 Monate postoperativ.

Ergebnisse

Die subfoveale AH-Dicke betrug bei 12 Patienten mit MF 274 ± 65 µm. Am gesunden Partnerauge der 10 Patienten maß die AH 268 ± 75 µm und bei 2 Patienten mit bilateralen MF am nicht operierten Partnerauge 309 ± 34 µm. Die Achsenlänge (AL) betrug bei Augen mit MF 23,64 ± 0,59 mm und bei gesunden Partneraugen 23,68 ± 0,54 mm. Postoperativ war bei allen Patienten das MF verschlossen, und die AH-Messung ergab 8 Wochen postoperativ 284 ± 77 µm und 6 Monate postoperativ 276 ± 73 µm.

Schlussfolgerung

Das EDI-OCT ermöglicht die Messung der AH-Dicke. In der hier untersuchten Patientengruppe ließ sich keine reduzierte AH-Dicke ermitteln. Der prä- und postoperative Vergleich der AH-Dicke ergab keinen signifikanten Unterschied. Im Gegensatz zu kürzlich publizierten Daten konnte keine AH-Verdünnung bei MF nachgewiesen werden.

Abstract

Background

The pathogenesis of idiopathic macular hole (MH) formation is not fully understood and the choroid might be involved in its etiology. Recently published data reported choroidal thickness (CT) to be significantly thinner in eyes with idiopathic MH and in fellow eyes compared to age-matched healthy controls [24].

Methods

The enhanced depth imaging (EDI) modus of the Spectralis OCT (Heidelberg Engineering, Heidelberg) was used to measure subfoveal CT in 12 patients with MH of which 2 suffered from bilateral MH. Measurements were manually acquired preoperatively using the horizontal foveal scan of the 7-line scan (5 × 30  perifoveal) with 100 averaged scans per scan, between the outer border of the retinal pigment epithelium and the inner scleral border. Additional CT measurements were obtained 8 weeks and 6 months postoperatively.

Results

Subfoveal CT of the 12 patients with MH (10 ♀, 2 ♂; 68 ± 7 years) was 274 ± 65 µm. The CT of the 10 patients with healthy fellow eyes measured 268 ± 75 µm and CT of the 2 patients with bilateral MH measured 309 ± 34 µm in the non-operated eye. The mean axial length (AL) in eyes with MH was 23.64 ± 0.59 mm and in healthy fellow eyes 23.68 ± 0.54 mm. After surgery MH closure was obvious in all eyes, the postoperative CT at 8 weeks measured 284 ± 77 µm and at 6 months 276 ± 73 µm.

Conclusions

The EDI-OCT procedure enables measurements of CT. In the patients studied a reduced CT could not be found neither in patients with macular holes nor in the fellow eyes. There was no significant change in CT comparing preoperative with postoperative measurements. In contrast to recently published data [24] no reduction in CT in idiopathic macular hole could be demonstrated.

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  1. Schwerpunkt Retinologie, Universitäts-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland

    K.B. Schaal, S. Pollithy &  S. Dithmar

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  1. K.B. Schaal
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  2. S. Pollithy
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  3. S. Dithmar
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Correspondence to S. Dithmar.

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Schaal, K., Pollithy, S. & Dithmar, S. Spielt die Aderhautdicke beim idiopathischen Makulaforamen eine Rolle?. Ophthalmologe 109, 364–368 (2012). https://doi.org/10.1007/s00347-012-2529-8

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