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Spontaneous Conversion of Lamellar Macular Holes to Full-Thickness Macular Holes: Clinical Features and Surgical Outcomes.

Authors :
Chehaibou I
Hubschman JP
Kasi S
Su D
Joseph A
Prasad P
Abbey AM
Gaudric A
Tadayoni R
Rahimy E
Source :
Ophthalmology. Retina [Ophthalmol Retina] 2021 Oct; Vol. 5 (10), pp. 1009-1016. Date of Electronic Publication: 2021 Jan 05.
Publication Year :
2021

Abstract

Purpose: To describe the clinical features and surgical outcomes of patients experiencing a spontaneous conversion of a lamellar macular hole (LMH) to a full-thickness macular hole (FTMH).<br />Design: Retrospective, multicenter, observational case series.<br />Participants: Patients with LMH who experienced a spontaneous conversion to FTMH and underwent FTMH surgery.<br />Methods: Clinical charts and OCT features of 20 eyes of 20 patients were reviewed.<br />Main Outcome Measures: OCT features and surgical outcomes of FTMH derived from LMH.<br />Results: The mean baseline visual acuity (VA) was 0.21 ± 0.19 logarithm of the minimum angle of resolution (logMAR) (20/32 Snellen equivalent [SE]). Epiretinal proliferation was noted in 18 eyes (90%), and 14 eyes (75%) had an epiretinal membrane. At the diagnosis of FTMH, the mean VA decreased to 0.61 ± 0.50 logMAR (20/81 SE) (P = 0.001). The mean FTMH diameter was 224.4 ± 194.8 μm, with 15 (75%) small (≤250 μm), 2 (10%) medium (>250-≤400 μm), and 3 (15%) large (>400 μm) FTMHs. Eighteen (90%) FTMHs were sealed after 1 surgery, and 2 (10%) required an additional procedure. At the last follow-up, the mean VA was increased to 0.29 ± 0.23 logMAR (20/38 SE) (P = 0.003), but did not significantly differ from the baseline VA (P = 0.071).<br />Conclusions: Patients with LMH may develop an FTMH with no evidence of vitreomacular traction. A tangential traction from an epiretinal membrane may contribute to its genesis, but a progressive loss of retinal tissue and an inherent weakness of the foveal architecture in LMH eyes could be sufficient. Most FTMHs derived from LMH had a small diameter, showed epiretinal proliferation, showed limited retinal hydration, and were associated with relatively poor surgical outcomes compared with idiopathic FTMH.<br /> (Copyright © 2021 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Details

Language :
English
ISSN :
2468-6530
Volume :
5
Issue :
10
Database :
MEDLINE
Journal :
Ophthalmology. Retina
Publication Type :
Academic Journal
Accession number :
33412307
Full Text :
https://doi.org/10.1016/j.oret.2020.12.023