Foveal Abnormality associated with epiretinal Tissue of medium reflectivity and Increased blue-light fundus Autofluorescence Signal (FATIAS)

Novel approaches to the assessment and treatment of lamellar macular hole

“…The points included in the preoperative hyper-FAF areas had a significantly lower RS compared with those in the normo-FAF areas, demonstrating that hyper-FAF area in LMH is not only a sign of macular pigment loss or displacement, but also a marker of functional damage. In support of these results, several authors have demonstrated a direct correlation between FAF and RS and how is important the integration FAF and RS and OCT in different retinal pathologies, as in the early diagnosis of age-related macular degeneration, in diabetic macular oedema and in vitreomacular interface disorders (Midena & Vujosevic 2016;Vujosevic et al 2010;Querques et al 2012;dell'Omo et al 2019). Residing OCT, FAF and microperimetry within a single instrument would make the correlation between functional and morphological information more immediate and accurate, with no need for complex imaging elaboration.…”

“…To confirm this, in all operated patients, the removed tissue showed the typical features of EP, with a dense appearance, a yellowish colour and a fluffy consistency. It is still controversial if LMH is a stable condition or an evolving process that may be a threat to visual function over time (Fujii et al 2002;Wolf et al 2004;Androudi et al 2009;Witkin et al 2010;Casparis et al 2011;Figueroa et al 2011;Parolini et al 2011;Theodossiadis et al 2011;Reibaldi et al 2012;Pang et al 2014;Dutra Medeiros et al 2015;Sato et al 2015;Frisina et al 2016;Midena & Vujosevic 2016;Frisina et al 2019aFrisina et al , 2019bLai et al 2016;Ko et al 2017;Choi et al 2018;Coassin et al 2018;dell'Omo et al 2018dell'Omo et al , 2019. Regarding the morphology of LMH, two components of its extension can be identified: a vertical one, directed towards the outer retinal layers and a tangential one, extended into the OPL.…”

“…The few studies on retinal sensitivity (RS) changes in LMH highlight a reduction in macular function with a preservation of fixation stability (FS) in eyes with LMH, and an improvement of RS outcomes after LMH surgery (Parravano et al 2013;Scaroni et al 2017). SW-FAF is extremely useful in the diagnosis of the early stage of LMH: a minimum inner foveal defect, not detectable by OCT, changes the macular pigment distribution, reducing the masking effect of it on the amount of FAF originating from retinal pigment epithelium (RPE) cells (dell'Omo et al 2019). For what regards the treatment, no agreement has been reached about the management of patients affected by LMH.…”

“…Reported surgical outcomes are encouraging, with restoration of a normal foveal contour in 50%-79%, and with BCVA gain in 63%-93% of eyes (Frisina et al 2019a(Frisina et al , 2019bDanielescu et al 2020). Full-thickness macular hole (FTMH) development is one of the most serious postoperative complications with an incidence between 1.9% and 16.6% (Wolf et al 2004;Androudi et al 2009;Witkin et al 2010;Casparis et al 2011;Figueroa et al 2011;Parolini et al 2011;Dutra Medeiros et al 2015;Sato et al 2015;Lai et al 2016;Ko et al 2017;Choi et al 2018;Coassin et al 2018;dell'Omo et al 2018dell'Omo et al , 2019. LMH is associated with M€ uller cells damage, and the surgical peeling of epiretinal tissue onto the LMH may damage the already weak and compromised scaffolding property of M€ uller cells.…”

Multimodal Imaging of Lamellar Macular Holes

“…Recently, dell'Omo et al [ 31 ] described a distinct vitreomacular interface disorder termed foveal abnormality associated with epiretinal tissue of medium reflectivity and increased blue light fundus autofluorescence signal (FATIAS) ( Figure 10 ) . Distinguishing features of FATIAS are an abnormal foveal contour either in the form of a step or in the form of a shallow foveal pit and reduced foveal thickness on SD-OCT imaging; the presence of a tissue of medium reflectivity on the innermost portion of the foveal pit; the absence of overt ERM or EP; the absence of intraretinal cysts or splitting/cavitation between the inner and outer retinal layers; the integrity of the outer retinal bands; an increased B-FAF signal at the fovea; good BCVA.…”