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Idiopathic macular hole is a full-thickness defect of retinal tissue involving the anatomic fovea and affecting central visual acuity and quality of life in elder patients. Recent evidence showed that the alterations of choroidal blood flow and choroidal thickness are associated with the formation of macular holes. Enhanced depth imaging spectral-domain optical coherence tomography(EDI SD-OCT)enables <i>in vivo</i> measurement of choroidal thickness and may provide new insight into the understanding of pathogenesis of idiopathic macular hole. In this article, we reviewed current studies on the relationship between choroidal thickness measured by optical coherence tomography and the pathogenesis of idiopathic macular hole.