目的：探讨脉络膜厚度和特发性黄斑前膜(idiopathic macular epiretinal membrane，IMEM)发生发展的关系。

方法：回顾性分析2014-01/2016-12期间我院就诊的IMEM患者48例48眼，并选取同期体检健康者50例的右眼进行对照，比较IMEM组患眼、健眼及对照组黄斑中心凹脉络膜厚度(subfoveal choroidal thickness，SFCT)水平，随访观察术后IMEM患者患眼及健眼SFCT水平变化，并分析术后脉络膜厚度和最佳矫正视力的相关性。

结果：术前IMEM组患眼SFCT(362.22±40.75μm)明显较对侧健眼(410.56±38.45μm)及对照组右眼(420.73±39.63μm)低，且对侧健眼较对照组右眼低，差异均有统计学意义(均P<0.05)。IMEM组患者术后1wk患眼和健眼SFCT与术前比较差异均无统计学意义(P>0.05)，而术后1mo患眼和健眼SFCT均显著升高，和术前相比差异有统计学意义(P<0.05)，此后SFCT值趋于稳定，而术后1mo患眼和健眼比较差异无统计学意义(P>0.05)； 术前不同SFCT值患者术后BCVA≥0.5患者构成比差异有统计学意义(P<0.05)，且SFCT值>380μm组术后BCVA≥0.5患者构成比明显较<320μm组和320～380μm组高，经Fisher确切概率法分析，差异有统计学意义。经Pearson分析，IMEM患者术后脉络膜厚度和术后最佳矫正视力存在正相关性(r=0.629，P<0.05)。

结论：脉络膜变薄可能是IMEM的重要诱因，且术前脉络膜厚度对术后视力恢复也有一定影响。

METHODS: A retrospective analysis on 48 cases(48 eyes)of idiopathic macular epiretinal membrane patients(the IMEM group)was taken in our hospital from January 2014 to December 2016, and 50 right eyes in 50 healthy persons with physical examination were selected the control group, comparison on subfoveal choroidal thickness(SFCT)levels of sicked eyes, normal eyes in IMEM group and the control group were made, postoperative SFCT level change of sicked eyes in IMEM patients and normal eyes were investigated via follow-up, and analysis on correlation between postoperative choroidal thickness and the best corrected visual acuity was taken.

RESULTS: The SFCT of sicked eyes in IMEM group 362.22±40.75μm was significantly lower than that of the contralateral eyes(410.56±38.45μm)and the right eyes of the control group(420.73±39.63μm), and data of the contralateral eyes was lower than right eyes of the control group, distinct difference was shown between groups(P<0.05). The IMEM group's SFCT of sicked eyes and normal eyes at postoperative 1wk had no significant difference with that before operation(P>0.05), and at postoperative 1mo, SFCT of sicked eyes and normal eyes evidently increased, showing sharp difference compared with that before operation(P<0.05). After that, the SFCT value stabilized, but there was no obvious difference between the sicked eyes and healthy eyes at postoperatively 1mo(P>0.05). The numbers of patients whose postoperative BCVA ≥0.5 with different preoperative SFCT values had statistically significant differences(P<0.05), and those with BCVA ≥0.5 of SFCT values> 380μm were significantly higher than those with <320μm and 320μm-380μm groups. Fisher exact probability analysis showed that the differences were significant. Pearson analysis showed that there was a positive correlation between the postoperative choroid thickness and the best corrected visual acuity of IMEM group(r=0.629, P<0.05).

CONCLUSION: Choroidal thinning may be an important cause of IMEM, and preoperative choroidal thickness also has an influential effect on postoperative visual recovery.