The natural history of lamellar macular holes: a spectral domain optical coherence tomography study

Bottoni, Ferdinando; Deiro, Antonio Peroglio; Giani, Andrea; Orini, Claudia; Cigada, Mario; Staurenghi, Giovanni

doi:10.1007/s00417-012-2044-2

Cited by 127 publications

(138 citation statements)

References 20 publications

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“…Also, LMH floor thickness seems to be thinner in LHEP eyes ( p = 0.018) when compared to that of the non-LHEP LMH group, a result that is in agreement with findings from previous studies [13, 17, 19]. Our case series did not find any differences regarding the aperture of the LMH between the 2 groups.…”

Section: Discussionsupporting

confidence: 92%

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Epiretinal Proliferations Associated with Lamellar Macular Holes: Clinical and Surgical Implications

et al. 2018

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Objectives: To describe the prevalence of lamellar hole-associated epiretinal proliferation (LHEP) and to correlate this finding with lamellar macular hole (LMH) morphology and prognosis after a surgical or conservative approach. Methods: This is a retrospective multicenter case series comprising consecutive LMH patients followed for ≥6 months. Serial spectral-domain optical coherence tomographies were evaluated for the presence of epiretinal membrane (ERM) and LHEP, diameter of the LMH aperture, base, and floor thickness. Pars plana vitrectomy with ERM and internal limiting membrane peeling was performed in the surgical cases. Results: A total of 62 eyes from 57 consecutive patients were included. Mean follow-up time was 27.1 ± 19.8 months. LHEP was observed in 33 (53.2%) eyes. Patients with LMH and LHEP presented a larger external diameter (p = 0.001) and thinner floors (p = 0.018). Twenty-seven (81.8%) of the patients with LMH and LHEP presented a degenerative intraretinal cavitation, compared to 23.3% in the non-LHEP group (p = 0.001). No differences were observed in visual performance or closure rate between the 2 groups after surgery or in the subset of patients followed conservatively. Conclusions: LHEP was correlated with the anatomical conformation of the LMH, yielding thinner floors and larger external diameters. However, it did not correlate with the anatomical or functional results, both in the patients who underwent surgery and in those managed conservatively.

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Section: Discussionsupporting

confidence: 92%

“…LHEP were initially described as a “thick ERM” [5, 19]. However, their SD-OCT features did not resemble conventional ERM [11], and the clinical implications of this newly described material have been investigated since its first report.…”

Section: Discussionmentioning

confidence: 99%

Epiretinal Proliferations Associated with Lamellar Macular Holes: Clinical and Surgical Implications

et al. 2018

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“…Thus, peeling of LHEP might be not as important for relieving epiretinal traction as peeling a standard ERM, but it would have the function of allowing surgical access to the ILM. The role of ILM as epiretinal material exerting traction in association with LMHs seems to be also confirmed by the fact that, as reported by previous studies, 5,12 and as observed in this series, full-thickness macular holes evolved from LMHs and associated with LHEP generally close after surgical removal of ILM.…”

Section: In This Retrospective Study We Show That In Eyessupporting

confidence: 90%

“…6,7,12 Blue fundus autofluorescence (B-FAF) imaging is a modality that relies on the fluorescence generated by the bisretinoids of lipofuscin in retinal pigment epithelial (RPE) cells and is influenced by absorbent or autofluorescent materials anterior to the RPE monolayer. 13,14 When imaged with B-FAF imaging, LMHs are characterized by an increased autofluorescent signal, the intensity of which does not correlate with the thickness of the residual outer retinal tissue.…”

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confidence: 99%

Role of Lamellar Hole–Associated Epiretinal Proliferation in Lamellar Macular Holes

dell’Omo

Virgili

Rizzo

et al. 2017

American Journal of Ophthalmology

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“…Visual acuity may be correlated with ERM type: A ERM is associated with lower visual acuity than C ERM. Figure 3a shows the comparison of BCVA between LMH associated with C ERM and LMH associated with A ERM ( p < 0.0001) [3, 4, 7-11, 22]. The difference in visual acuity may be explained by a greater involvement of outer intraretinal layers ( p = 0.0003) and of the ellipsoid zone and external limiting membrane (ELM), and by a lower residual foveal thickness in LMH associated with A ERM than in LMH associated with C ERM ( p = 0.00001) [3, 4, 8-10, 22] (Fig.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Lamellar Macular Hole: State of the Art

Frisina

Pilotto

Midena³

2019

Ophthalmic Res

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Lamellar macular hole (LMH) is a vitreoretinal disorder characterized by an irregular foveal contour, a break in the inner fovea, dehiscence of the inner foveal retina from the outer retina, and the absence of a full-thickness foveal defect with intact foveal photoreceptors. The pathogenesis is only partially known. The advent of high-resolution optical coherence tomography has allowed distinguishing between two types of epiretinal membrane (ERM) associated with LMH: a conventional ERM (commonly found in macular pucker) and an atypical ERM (known by varied names: dense, epiretinal proliferation, or degenerative). These two types of ERM not only influence LMH morphology but also differ in cell and collagen composition. It remains unclear if these two types are indeed two distinct clinical entities or rather two stages of the same macular disorder. Studies of the natural evolution of LMH have not fully resolved this issue and also offered variable results. Surgical treatment leads to excellent anatomical and functional outcomes, but not without risks. This review provides a critical summary of the available data on LMH including some new insights.

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The natural history of lamellar macular holes: a spectral domain optical coherence tomography study

Abstract: Lamellar macular holes seem to be a stable macular condition. Vitrectomy should be considered only in the presence of progressive thinning of foveal thickness and/or decrease of visual acuity during the follow-up of the disease.

Cited by 127 publications

References 20 publications

Epiretinal Proliferations Associated with Lamellar Macular Holes: Clinical and Surgical Implications

Epiretinal Proliferations Associated with Lamellar Macular Holes: Clinical and Surgical Implications

Role of Lamellar Hole–Associated Epiretinal Proliferation in Lamellar Macular Holes

Lamellar Macular Hole: State of the Art

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