LAMELLAR HOLE-ASSOCIATED EPIRETINAL PROLIFERATION IN LAMELLAR MACULAR HOLE AND FULL-THICKNESS MACULAR HOLE IN HIGH MYOPIA

Herein, we report the longitudinal observation of a case with reopening of the macular hole associated with a lamellar macular hole-associated epiretinal proliferation (LHEP) followed by spontaneous closure in patients with stage 2 idiopathic macular hole. A 64-year-old woman was referred for the decreased visual acuity (VA) and acute anorthopia in the right eye. Funduscopy and optical coherence tomography (OCT) showed stage 2 full-thickness macular hole without posterior vitreous detachment (PVD) and operculum formation. Her best-corrected visual acuity (BCVA) was 20/32. One month later, the diameter of the macular hole was getting small and VA improved. Six months later, the macular hole was treated spontaneously with the attached hyaloid membrane to the macula by OCT and the BCVA improved to 20/20. Fourteen months after the first visit, the BCVA decreased to 20/50 and the patient was diagnosed with stage 4 macular hole with complete PVD. OCT showed full-thickness macular hole with a LHEP in the right eye. After 25G-gauge vitrectomy with the peeling of internal limiting membrane (ILM) and LHEP, the macular hole was closed and BCVA finally improved to 20/25. Spontaneous macular hole closure without PVD may rarely occur in patients with LHEP. The surgical removal of ILM and LHEP may contribute to the successful macular hole closure after vitrectomy.

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Lamellar macular holes: evolving concepts and propensity for progression to full thickness macular hole

International Journal of Retina and Vitreous ◽

10.1186/s40942-020-00252-x ◽

2020 ◽

Vol 6 (1) ◽

Cited By ~ 1

Author(s):

Salim Zafar Asaad

Keyword(s):

Macular Hole ◽

Clinical Course ◽

Morphological Changes ◽

Wide Spectrum ◽

Tissue Loss ◽

Lamellar Macular Hole ◽

Full Thickness ◽

Macular Holes ◽

Full Thickness Macular Hole ◽

Tractional Forces

Abstract Currently the term lamellar macular hole (LMH) alludes to a wide spectrum of macular conditions including distinct clinical entities with different pathomorphologies. Classifications into subtypes, tractional and degenerative or based on the associated preretinal tissue had been proposed. Recent insights suggest that only lesions with tissue loss should be considered ‘true’ LMH and not those morphological changes caused by tractional forces. Inclusion of lesions with foveoschisis with contractile epiretinal membrane (ERM) in earlier studies on LMHs has resulted in imprecise information about its clinical course. This review provides an overview of the evolving concepts of LMHs and analyses its natural history from study cases in previously published literature.

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The Comparison of the Surgical Outcome for the Full-Thickness Macular Hole with/without Lamellar Hole-Associated Epiretinal Proliferation

Journal of Ophthalmology ◽

10.1155/2017/9640756 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Yuri Ubukata ◽

Hisanori Imai ◽

Keiko Otsuka ◽

Masaya Nishizaki ◽

Rumiko Hara ◽

...

Keyword(s):

Macular Hole ◽

Surgical Outcome ◽

Full Thickness ◽

External Limiting Membrane ◽

Minimum Diameter ◽

Corrected Visual Acuity ◽

Full Thickness Macular Hole ◽

Pars Plana ◽

The Mean ◽

Lamellar Hole

Aims. To compare the surgical outcome of pars plana vitrectomy (PPV) for full-thickness macular hole (FTMH) with and without lamellar hole-associated epiretinal proliferation (LHEP). Methods. This retrospective study included 158 eyes of 158 patients with FTMH treated with PPV. The following variables were analyzed: sex, age, preoperative best corrected visual acuity (pre-BCVA), BCVA 6 months after the surgery (6M-BCVA), the axial length of eye, the minimum diameter of FTMH, the diameter of basal side of FTMH, postoperative continuity of subfoveal ellipsoid zone (EZ) and external limiting membrane (ELM), and the preoperative presence of LHEP. Results. Twenty-eight eyes had FTMH with LHEP and 130 without LHEP. The mean ± SD age (years) was 72.6 ± 7.9 and 68.6 ± 8.7, respectively (p=0.02). 6M-BCVA was 0.38 ± 0.30 and 0.26 ± 0.25, respectively (p=0.03). The diameter of basal side of FTMH (μm) was 901.5 ± 404.9 and 658.9 ± 288.1, respectively (p=0.00027). EZ was disrupted in 24 eyes and 63 eyes, respectively (p=0.00071). ELM was disrupted in 15 eyes and 23 eyes, respectively (p=0.00015). The FTMH diameters and the presence of LHEP were inversely correlated with the continuity of EZ and ELM. Conclusion. The preoperative appearance of LHEP could be one of the prognostic factor for the treatment of FTMH.

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