Lamellar Hole–associated Epiretinal Proliferation

Abstract

Lamellar macular hole with LHEP may demonstrate closure after pars plana vitrectomy with LHEP and internal limiting membrane peeling and gas tamponade. There was considerable improvement in visual acuity. It is possible that LHEP originates from middle retinal layers of the lamellar hole defect because it contains retinal glial cells, specifically Müller cells.

Clinical Presentation and Disease Course of Usher Syndrome Because of Mutations in Myo7a or Ush2a

“…Thus, it is thought that the LHEP may be a response to hole formation rather than a cause-that is, the LHEP is not thought to exert traction contributing to hole formation. [14][15][16] Consistent with this hypothesis, the LHEP identified in this study was found in association with an eccentric macular hole in an area of retinitis that presumably occurred secondary to atrophy from CMV retinitis rather LHEPinduced traction.…”

Evidence of Carotenoid in Surgically Removed Lamellar Hole-Associated Epiretinal Proliferation

“…Our histological analysis was preliminary, and we cannot definitively conclude that LHEP originates either from the retina 5,10 or from the vitreous. 3,4 Our present RRM results also cannot show that carotenoid-specific signals come from the Müller cells.…”

“…Pang et al 10 demonstrated histologically that LHEP was composed of proliferated Müller cells and argued that LHEP originates from the retina. 5 The GFAP-positive immunostaining of LHEP in the present study corroborated their findings.…”

“…However, the origin of LHEP has not been determined. Pang et al 10 argued that LHEP originates from the Müller cells in association with retinal defects, and revealed that LHEP was histopathologically composed of proliferated Müller cells. On the contrary, Compera et al 11 mentioned that LHEP originated from the vitreous and comprised fibroblasts, hyalocytes, and type II collagen.…”

“…LHEP typically appears yellowish 10 when it is removed surgically. Since no yellow pigment is reported to exist in the retina other than macular pigment, the yellow pigment in LHEP is speculated to be related to the carotenoids of macular pigment.…”