Journal List > J Korean Ophthalmol Soc > v.53(9) > 1009167

Choi, Kim, Lee, Moon, and Yoon: Visual and Surgical Outcomes of Lamellar Macular Hole

Abstract

Purpose

To investigate the visual and anatomical results of surgical treatment for symptomatic lamellar macular hole.

Methods

Ten eyes of ten patients with decreased visual acuity and lamellar macular hole were diagnosed using optical coherence tomography (OCT). Pars plana vitrectomy, epiretinal membrane removal, internal limiting membrane peeling, and gas tamponade (5 eyes) were performed for the treatment of lamellar hole. The resolution of the lamellar hole was assessed in relation to each OCT image at baseline.

Results

The mean postoperative follow-up duration was 7.5 months, and best corrected visual acuity improved from log MAR 0.67 ± 0.38 to log MAR 0.30 ± 0.28. Central foveal thickness decreased from 441 ± 184 µm to 291 ± 64 µm. The OCT of all eyes demonstrated improvement in macular contour. However, retinal detachment in one eye occurred at two months after the operation and was reattached with gas tamponade and photocoagulation.

Conclusions

Vitrectomy, epiretinal membrane removal and internal limiting membrane peeling showed benefit in the treatment of symptomatic lamellar macular hole. However, large and prospective studies are necessary regarding the surgical indication, time and procedure for lamella macular hole.

Figures and Tables

Figure 1
(A) Preoperative OCT images with visual acuity log MAR 0.40 and foveal thickness 357 µm. This image fulfills the criteria for OCT diagnosis of lamellar hole: (1) irregular foveal contour; (2) dehiscence in the inner fovea; (3) separation of the inner from the outer foveal retinal layers, leading to an intraretinal split; (4) absence of a full-thickness foveal defect. (B) OCT at 2 months after operation with visual acuity log MAR 0.22 and foveal thickness 331 µm.
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Table 1
Characteristics of patients before and after operation
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VA = visual acuity; CMT = central macular thickness; PPV = Pars plana vitrectomy; memb = epiretinal membrane peeling; ILM = internal limit membrane peeling.

Table 2
Summary of preoperative and postoperative information
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Values are presented as mean ± SD or number.

VA = visual acuity; CMT = central macular thickness.

*p = 0.008; p = 0.005.

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