Epiretinal Membrane–induced Full-Thickness Macular Holes

Abstract

Epiretinal membrane-induced FTMH has distinct features from the typical Stage 2 or 4 FTMH. Despite the small size, visual improvement is not as good as that in Stage 2 FTMH.

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

“…It has been already reported that the preoperative smaller FTMH diameter was a prognostic factor of better postoperative functional and structural outcomes [ 12 ]. The notable result in our study was the inverse relationships of the presence of LHEP with postoperative functional and morphological outcomes, which is consistent with the previous study [ 10 ]. These results strongly support the hypothesis that FTMH with LHEP develops first with processes of photoreceptor damage following LMH formation and later outer laminar dehiscence.…”

“…In this study, there was no difference in the smallest FTMH diameter between FTMH with and without LHEP. This result is at odd with previous reports [ 10 , 11 ]. This discrepancy in results may be due to the existence of two different shapes in FTMH with LHEP.…”

“…Generally, the diameter of FTMH tends to get larger along with a prolonged period of FTMH and a progress of disease stage. We believe our result is reasonable because the disease duration in FTMH with LHEP is thought longer than idiopathic FTMH because many cases in this type of FTMH originate from LMH and had repeated episodes of spontaneous hole closure followed by subsequent reopening, which resulted in the formation of the larger FTMH [ 10 , 11 ]. This is also indicated in our study from the finding that FTMH with LHEP was observed in older patients.…”

“…The definition of LHEP was solely made by the OCT findings in the previous reports. On the other hand, Tsai et al have reported that yellowish pigment around the FTMH was noticed in 10% of stage 2 FTMH and 13.6% of stage 4 FTMH, without OCT evidence of LHEP [ 10 ]. We included the case, which had yellowish pigment around the FTMH, as the presence of LHEP in this study.…”

A Review of Surgical Outcomes and Advances for Macular Holes

“…A less common mechanism of MH formation is by ERM traction, usually on a lamellar macular hole (LMH) [ 52 ]. Recently, a study proposed by Pang and associates [ 53 ] found that the lamellar hole-associated epiretinal proliferation (LHEP) appears on SD-OCT images as a substantial material of homogenous medium reflectivity located on the epiretinal surface, which is a unique feature in LMH or LMH-induced full-thickness macular hole (FTMH).…”