Lamellar Macular Hole as the Presenting Feature in a Child With Coats' Disease

Ioannidis, Alexander S; Liasis, Alki; Sheldrick, J H; Snead, Martin P.; Nischal, Ken K.

doi:10.3928/01913913-20051101-09

Cited by 10 publications

(5 citation statements)

References 4 publications

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“…Eyes with conditions complicated by chronic CME such as the Irvine-Gass syndrome [ 3 , 4 ], diabetic macular edema [ 78 ], ( Figure 4 ) retinal vein occlusions [ 78 , 79 , 80 , 81 , 82 ], retinochoroiditis [ 83 ], oculocutaneous albinism [ 84 ], age-related macular degeneration [ 85 , 86 ], ( Figure 5 ) retinitis pigmentosa [ 87 ], X-linked retinoschisis [ 88 ], myotonic dystrophy, Alport syndrome [ 89 ], Coats’ disease [ 90 ], high myopia [ 91 , 92 , 93 , 94 ], proliferative diabetic retinopathy [ 95 ], familial exudative vitreoretinopathy [ 96 ] and ocular trauma [ 97 , 98 ] may experience a spontaneous dehiscense of the roof of a cystoid space causing a LMH. This dehiscense may be triggered by vitreomacular traction by either an epiretinal membrane or the posterior hyaloid [ 78 , 99 , 100 ].…”

Section: Pathogenesismentioning

confidence: 99%

Primary Lamellar Macular Holes: To Vit or Not to Vit

Bradshaw

2022

JCM

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There is a wide spectrum of macular conditions that are characterized by an irregular foveal contour caused by a break in the inner fovea. These include full-thickness macular hole (FTMH), foveal pseudocyst, lamellar macular hole (LMH) and macular pseudohole (MPH). Clinical examination of vitreomacular interface disorders is notoriously poor in differentiating these conditions. These conditions were initially described with slit-lamp biomicroscopy, and the main goal was to distinguish an FTMH from the others. The introduction of optical coherence tomography (OCT) has revolutionized our understanding of the foveal microstructural anatomy and has facilitated differentiating these conditions from an FTMH. However, the definitions of the other conditions, particularly LMH, has evolved over the past two decades. Initially the term LMH encompassed a wide spectrum of clinical conditions. As OCT became more widely used and observations became more refined, two different phenotypes of LMH became apparent, raising the question of different pathogenic mechanisms for each phenotype. Tractional and degenerative pathological mechanisms were proposed. Epiretinal membranes (ERMs) associated with each phenotype were identified. Typical ERMs were associated with a tractional mechanism, whereas an epiretinal proliferation was associated with a degenerative mechanism. Epiretinal proliferation represents Müller cell proliferation as a reactive process to retinal injury. These two types of ERM were differentiated by their characteristics on SD-OCT. The latest consensus definitions take into account this phenotypic differentiation and classifies these entities into LMH, MPH and ERM foveoschisis. The initial event in both ERM foveoschisis and LMH is a tractional event that disrupts the Müller cell cone in the foveola or the foveal walls. Depending on the extent of Müller cell disruption, either a LMH or an ERM foveoschisis may develop. Although surgical intervention for LMH remains controversial and no clear guidelines exist for pars plana vitrectomy (PPV), eyes with symptomatic, progressive ERM foveoschisis and LMH may benefit from surgical intervention.

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Section: Pathogenesismentioning

confidence: 99%

Primary Lamellar Macular Holes: To Vit or Not to Vit

Bradshaw

2022

JCM

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“…In previous reports, OCT findings in FTMH with Coats disease have included 1 case with thin membranous tissue [3], 1 case with epiretinal membrane (ERM) [6], and 2 cases with no macular traction [4,5]. In the present case, OCT showed no sign of vitreomacular traction, ERM.…”

Section: Discussionmentioning

confidence: 44%

“…FTMH with Coats disease has rarely been reported [3][4][5][6][7][8] and the pathogenesis of FTMH is unknown. To our knowledge, this is the first report of a patient with Coats disease who developed FTMH.…”

Section: Discussionmentioning

confidence: 99%

“…Coats disease is characterized by the occurrence of abnormal retinal telangiectasia with massive intraretinal and subretinal exudates of ﬂuid and lipid, capillary nonperfusion, and exudative retinal detachment [ 1 ]. Coats disease presents with many clinical features and complications [ 2 ]; however, the development of full-thickness macular hole (FTMH) in Coats disease is particularly rare [ 3 , 4 , 5 , 6 ]. The etiology of FTMH in Coats disease is unknown.…”

Section: Introductionmentioning

confidence: 99%

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Full-Thickness Macular Hole with Coats Disease: A Case Report

Hashimoto¹,

Arai²,

Makino³

et al. 2020

Case Rep Ophthalmol

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We report a case of full-thickness macular hole (FTMH) which developed during follow-up for Coats disease. To our knowledge, this is the first report on a case of FTMH which developed during follow-up for Coats disease. A 17-year-old boy was referred to our institution with blurred vision in his left eye. Fundus examination showed yellowish subretinal exudates with overlying telangiectatic retinal vessels in the temporal periphery in the left eye; the right eye was normal. Fluorescein angiography revealed diffusion indicative of temporal peripheral vascular leakage. We made a diagnosis of stage 2A Coats disease and performed argon laser photocoagulation (PC). Moreover, he received intravitreal injection of anti-vascular endothelial growth factor. At 30 months after the first visit, the best-corrected visual acuity (BCVA) of the left eye worsened to 20/50. We observed tensioned internal limiting membrane (ILM), serous macular detachment (SMD) and retinal thinning; the intraretinal exudate remained. We performed PC and at 36 months after the first visit, BCVA further declined to 20/63 in his left eye and FTMH was observed. We then performed a 27-gauge pars plana vitrectomy and ILM peeling following which the FTMH was found to have closed by 4 days after vitrectomy. SMD gradually decreased, and BCVA improved to 20/20. Chronic inflammation by peripheral vascular leakage and PC application might have caused FTMH. In this case, the vitrectomy for FTMH with Coats disease provided good visual and anatomic outcomes.

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“…e presence of an operculum in front of the fovea would confirm this pathogenic theory [7]. ere are several papers describing the advent of LMHs in diseases associated with CME: post cataract surgery [1], diabetic macular edema [8], retinitis pigmentosa [9], and Coats' disease [10]. However, most cases of LMH are considered idiopathic [7] and it seems the pathogenesis of LMH cannot simply be attributed to abortive anteroposterior traction [11].…”

Section: Introductionmentioning

confidence: 99%

The Management of Lamellar Macular Holes: A Review

Danielescu

Stanca

Baltă

2020

Journal of Ophthalmology

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is literature review aims to provide the retina specialist with answers to patient's questions related to the management of lamellar macular holes (LMHs). Most LMHs are stable over time, but 13-21% present an anatomic decline after 18-24 months of follow-up. Nineteen point five percent of the eyes may experience a visual acuity (VA) loss of more than 5 letters after 3 years. Many surgeons choose to perform surgery when there is significant metamorphopsia or documented decline in VA over time. e typical surgery is phacovitrectomy with the epiretinal membrane and the internal limiting membrane peeling in previously phakic eyes (41.9 to 85.3% of the eyes). In the eyes that remained phakic, cataract surgery was often necessary within the first year of follow-up (19.2 to 40% of eyes). After surgery, a VA gain was recorded in 63-94% of eyes, but some eyes (between 0 and 20%) suffered some VA loss. Progression to full-thickness macular hole may occur after surgery, and thus a second surgical intervention may be needed.

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Lamellar Macular Hole as the Presenting Feature in a Child With Coats' Disease

Abstract: We report a case of Coats' disease and lamellar macular hole in a 10-year-old boy who presented with blurring of vision in his left eye. This is the first reported case of Coats' disease presenting with a lamellar macular hole in a child. J Pediatr Ophthalmol Strabismus 2005;42:378–379.

Cited by 10 publications

References 4 publications

Primary Lamellar Macular Holes: To Vit or Not to Vit

Primary Lamellar Macular Holes: To Vit or Not to Vit

Full-Thickness Macular Hole with Coats Disease: A Case Report

The Management of Lamellar Macular Holes: A Review

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