Long-term follow-up of fellow eye in patients with lamellar macular hole

Nava, Ugo; Cereda, Matteo Giuseppe; Bottoni, Ferdinando; Preziosa, Chiara; Pellegrini, Marco; Giani, Andrea; Staurenghi, Giovanni

doi:10.1007/s00417-017-3652-7

Cited by 12 publications

(11 citation statements)

References 27 publications

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“…Bilateral LMH appears to be a relatively uncommon occurrence [ 23 ]. A retrospective study of 35 individuals with a LMH revealed that in the fellow eye, 83% had a vitreomacular abnormality.…”

Section: Epidemiologymentioning

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: Epidemiologymentioning

confidence: 99%

Primary Lamellar Macular Holes: To Vit or Not to Vit

Bradshaw

2022

JCM

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“…According to the pathological hypothesis of LMH as an abortive process of FTMH, such a complication can occur. 13 , 14 It should be considered whether vitrectomy at an earlier stage can prevent FTMH development.…”

Section: Discussionmentioning

confidence: 99%

“… 2 , 3 , 8–12 One hypothesis is that it could occur after PVD as an abortive process of a full thickness macular hole (FTMH) formation. 13 , 14 …”

Section: Introductionmentioning

confidence: 99%

Outcomes from the Retrospective Multicenter Cross-Sectional Study on Lamellar Macular Hole Surgery

Haave¹,

Petrovski²,

Zając³

et al. 2022

OPTH

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Purpose To analyze the functional and anatomical parameters of lamellar macular hole (LMH) surgery with internal limiting membrane peeling and determine which surgical technique provides the best visual outcome. Methods This is a retrospective multicenter cross-sectional study on patients who underwent pars plana vitrectomy (PPV) for LMH with or without combined phaco-vitrectomy, as well as gas-, air- or BSS-tamponade. Pre- and postoperative examination included best corrected visual acuity (BCVA) measurements for functional comparison and optical coherence tomography (OCT) scans to determine the contributing anatomical parameters. Results A total of 66 consecutive patients were included (age: 71.79 ± 8.52 years), of which 47 (71.2%) were diagnosed as tractional type LMH, and 19 patients (28.8%) as degenerative type. An epiretinal membrane (ERM) was present in 63 of the patients (95.5%), LMH-associated epiretinal proliferation (LHEP) was present in 19 patients (28.8%), and 16 patients (24.2%) had concomitant ERM and LHEP. In the group of tractional LMH, the mean central foveal thickness (CFT) was 81.1% thicker (P < 0.05) than in the degenerative group. Thirty-one patients (47.0%) underwent a combined phaco-vitrectomy procedure, while the rest underwent 23G, 25G or 27G PPV. Seventeen of the 66 patients received gas-tamponade (25.7%)-either SF 6 or C 3 F 8 , 26 received air-tamponade (39.4%), while the remaining 23 patients received balanced salt solution (BSS)-tamponade (34.9%) during vitrectomy. The total BCVA showed significant improvement postoperatively (p < 0.001) and accordingly in the following groups: tractional LMH type (p < 0.001), degenerative type (p < 0.001), simple PPV (p < 0.001), phaco-vitrectomy (p < 0.001), BSS injection (p < 0.01), gas-tamponade (p < 0.05). None of the patients included in the study developed a full thickness macular hole postoperatively. Conclusion PPV provided a high success rate and functional improvement for treating LMH for both tractional and degenerative types, as well as combined phaco-vitrectomy treatment when cataract was present.

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“…23–25 A higher occurrence of bilateral macular disorders and pathological changes in the morphology of the vitreoretinal interface have also been noted in the fellow eyes over a longer time span. 26,27…”

Section: Discussionmentioning

confidence: 99%

“…[23][24][25] A higher occurrence of bilateral macular disorders and pathological changes in the morphology of the vitreoretinal interface have also been noted in the fellow eyes over a longer time span. 26,27 Interestingly, Kay and colleagues 28 reported increased familial occurrence of MHs in patients with idiopathic MH, as compared with controls. This trend was more common in patients with bilateral MH, a factor which was seen to persist even after disregarding confounding factors such as age and number of relatives suffering from the syndrome.…”

Section: Discussionmentioning

confidence: 99%

A multifocal electroretinography study to evaluate risk of developing macular hole in the fellow eye of patients suffering with unilateral macular hole

et al. 2020

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Background: Visual outcome of eyes has often been found to be unsatisfactory even after successful closure of a macular hole, owing to factors like persistent metamorphopsia, scotoma, and reduced sensitivity. Therefore, it becomes critical to evaluate and study the probability and risk of developing a macular hole in the fellow eyes of the patient. This study analyzed the multifocal electroretinographic responses to help predict the risk of macular hole development in fellow eyes. Methods: In total 26 fellow eyes, 26 eyes with macular hole, and 50 eyes of 25 controls were enrolled prospectively. The retinal responses from the different rings were compared in the three groups. Optical coherence tomography was done to rule out macular pathology or vitreomacular traction in the fellow eyes. Results: All the fellow eyes under observation showed significantly reduced mean amplitudes of retinal response densities, in all rings as compared with controls (31.45 ± 10.38 versus 48.87 ± 7.55, p = 0.00). Three of the fellow eyes developed a macular hole during the 24 months observation period. The prevalence of fellow eye involvement was 11.5%. Relative risk of developing macular hole in the fellow eye ranged from 25 to 75. Conclusion: All the fellow eyes, including those that did not develop a macular hole, showed significantly reduced responses on multifocal electroretinogram. This indicates that macular hole may not be a focal disease. It may have widespread functional deficit which is bilateral in nature and suggestive of a degenerative or ischemic insult.

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Long-term follow-up of fellow eye in patients with lamellar macular hole

Cited by 12 publications

References 27 publications

Primary Lamellar Macular Holes: To Vit or Not to Vit

Primary Lamellar Macular Holes: To Vit or Not to Vit

Outcomes from the Retrospective Multicenter Cross-Sectional Study on Lamellar Macular Hole Surgery

A multifocal electroretinography study to evaluate risk of developing macular hole in the fellow eye of patients suffering with unilateral macular hole

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