Marco Frederico Marques1,2, Sónia Rodrigues3, Miguel Raimundo1, José Costa1, João Pedro Marques1,2,4, Mário Alfaiate1, João Figueira1,2,3,4,5. 1. Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal. 2. Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal. 3. Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal. 4. Unidade de Oftalmologia de Coimbra (UOC), Coimbra, Portugal. 5. Espaço Médico de Coimbra (EMC), Coimbra, Portugal.
Abstract
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.
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.
Authors: Esther Lee Kim; Adam J Weiner; Cindy Ung; Miin Roh; Jay Wang; Ivan J Lee; Natalie T Huang; Maxwell Stem; Mohammad Dahrouj; Dean Eliott; Demetrios G Vavvas; Lucy H Y Young; George A Williams; Bruce R Garretson; Ivana K Kim; Tarek S Hassan; Shizuo Mukai; Alan J Ruby; Lisa J Faia; Antonio Capone; Jason Comander; Leo A Kim; David M Wu; Kimberly A Drenser; Maria A Woodward; Jeremy D Wolfe; Yoshihiro Yonekawa Journal: Ophthalmol Retina Date: 2019-04-01