Role of Lamellar Hole–Associated Epiretinal Proliferation in Lamellar Macular Holes

dell’Omo, Roberto; Virgili, Gianni; Rizzo, Stanislao; Turris, Serena De; Coclite, Giovanni; Giorgio, Dario; dell’Omo, Ermanno; Costagliola, Ciro

doi:10.1016/j.ajo.2016.11.007

Cited by 77 publications

(110 citation statements)

References 22 publications

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“…Also, LMH floor thickness seems to be thinner in LHEP eyes ( p = 0.018) when compared to that of the non-LHEP LMH group, a result that is in agreement with findings from previous studies [13, 17, 19]. Our case series did not find any differences regarding the aperture of the LMH between the 2 groups.…”

Section: Discussionsupporting

confidence: 92%

“…Also, histology suggests that this tissue does not have as much contractility as typical high-reflective ERM which, unlike LHEP, stains positive for myofibroblasts’ actin [5, 12]. Nevertheless, it has been postulated that traction associated with LHEP may be in fact due to ILM contraction, which can be underestimated because of the smooth inner surface of the LHEP which adjusts to the underlying ILM [17]. The overall findings in our study and analogous studies are depicted in Tables 2-4.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with LHEP have been reported to have worse baseline best-corrected visual acuities (BCVA), greater external LMH diameters, thinner floor thicknesses, and higher ellipsoid band disruption rates when compared to non-LHEP patients with LMH [10, 13, 16, 17]. In spite of these anatomical differences, most studies report no statistically significant results regarding LHEP-related LMH prognosis either with observation or after surgical management [4, 13, 14], with one paper reporting a worse visual outcome for patients with LMH and LHEP after surgery [10], and another citing an increase in LMH dimensions in correlation with the area of the LHEP [18].…”

Section: Introductionmentioning

confidence: 99%

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Epiretinal Proliferations Associated with Lamellar Macular Holes: Clinical and Surgical Implications

et al. 2018

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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.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Epiretinal Proliferations Associated with Lamellar Macular Holes: Clinical and Surgical Implications

et al. 2018

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“…6 These findings were supported by other investigations. 7 The baseline visual acuity, as well as improvement of visual acuity after surgery, has been reported as worse in LMH with LHEP, 8 although the results are controversial. 7 Govetto et al 9 suggested the possibility of three different mechanisms underlying the development of LMH, degenerative LMH, tractional LMH, and a combination of them.…”

mentioning

confidence: 99%

“…7 The baseline visual acuity, as well as improvement of visual acuity after surgery, has been reported as worse in LMH with LHEP, 8 although the results are controversial. 7 Govetto et al 9 suggested the possibility of three different mechanisms underlying the development of LMH, degenerative LMH, tractional LMH, and a combination of them. They suggested that LHEP was associated with degenerative LMH; thus, LHEP is a very important characteristic sign to consider the mechanism of LMH development and its prognosis.…”

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confidence: 99%

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

Obana

Sasano

Okazaki

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To determine the constituents and origin of the yellow pigment in surgically removed lamellar hole-associated epiretinal proliferation (LHEP) in patients with lamellar macular hole (LMH).METHODS. This prospective case series comprised nine eyes with LMH in patients aged 41 to 83 years. The presence of LHEP was confirmed by preoperative optical coherence tomography; the distribution of macular pigment was observed by two-wavelength fundus autofluorescence technique before and after surgery. The subjects underwent a 25-gauge vitrectomy, and the surgically removed epiretinal membranous tissue was fixed with formalin. The specimens were examined using resonance Raman microscopy, and paraffin sections were stained with antiglial fibrillary acidic protein.RESULTS. Seven cases presented with LHEP, and the presence of yellow pigment was confirmed using an operating microscope. Carotenoid-specific Raman signals with three major Raman peaks could be identified in the specimens with LHEP. These specimens were positive for glial fibrillary acidic protein staining. Using the fundus autofluorescence technique, a central defect in the distribution of the macular pigment was noted in the exact area of the lamellar hole. This type of defect was no longer visible after surgical repair of the lamellar hole.CONCLUSIONS. The constituents of the yellow pigment in the removed LHEP were carotenoids that typically originate from the macular xanthophyll pigments at the fovea. Since LHEP is reported to be composed of Müller cells, we hypothesize that xanthophyll carotenoids at the fovea are contained in the Müller cells.

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Surgical interventions for degenerative lamellar macular holes

Murphy

Rees

Steel

2020

Cochrane Database of Systematic Reviews

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Role of Lamellar Hole–Associated Epiretinal Proliferation in Lamellar Macular Holes

Cited by 77 publications

References 22 publications

Epiretinal Proliferations Associated with Lamellar Macular Holes: Clinical and Surgical Implications

Epiretinal Proliferations Associated with Lamellar Macular Holes: Clinical and Surgical Implications

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

Surgical interventions for degenerative lamellar macular holes

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