Skip to main content

Advertisement

SpringerLink
Log in

The natural history of lamellar macular holes: a spectral domain optical coherence tomography study

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Background

To study the evolution of lamellar macular holes (LMHs) using spectral domain-optical coherence tomography (SD-OCT).

Methods

Thirty-four consecutive patients diagnosed with a LMH were followed prospectively at Sacco University Hospital from October 2008 to January 2011. Inclusion criteria were a foveal defect on SD-OCT with residual foveal tissue above the retinal pigment epithelium and corresponding hyperautofluorescence on fundus autofluorescence imaging. Epiretinal membranes (ERMs) were categorized by SD-OCT at baseline as two different types: normal and thicker than normal. Best corrected visual acuity (BCVA) and SD-OCT findings were collected and compared at baseline and every 6 months thereafter. Active eye tracking technology ensured that the same scanning location was identified on follow-up visits. Main outcome measures were visual acuity changes (Early Treatment Diabetic Retinopathy charts) and progression of the lamellar macular defect. The influence of ERM type on disease progression was also evaluated.

Results

The patients included 15 males and 19 females with a mean age of 73 years and mean refraction of −0.25 diopters. The mean follow-up period was 18 months (range 6 to 24 months). BCVA at baseline (±standard deviation) was 63 ± 6 letters and did not change significantly during the follow-up period (P = 0.256). Foveal thickness at baseline, 180 ± 29 μm, was also stable (P = 0.592). All eyes had an ERM at baseline. Both thicker and normal ERMs showed similar functional and morphological evolution during follow-up with no significant changes. Two LMHs (5.8 %) developed a full thickness macular hole after 6 and 15 months follow-up respectively.

Conclusions

Lamellar macular holes seem to be a stable macular condition. Vitrectomy should be considered only in the presence of progressive thinning of foveal thickness and/or decrease of visual acuity during the follow-up of the disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11

Similar content being viewed by others

References

  1. Gass JDM (1976) Lamellar macular hole: a complication of cystoid macular edema after cataract extraction. Arch Ophthalmol 94:793–800

    Article  PubMed  CAS  Google Scholar 

  2. Gaudric A, Haouchine B, Massin P, Paques M, Blain P, Erginay A (1999) Macular hole formation: new data provided by optical coherence tomography. Arch Ophthalmol 117:744–751

    Article  PubMed  CAS  Google Scholar 

  3. Takahashi H, Kishi S (2000) Tomographic features of a lamellar macular hole formation and a lamellar hole that progressed to a full-thickness macular hole. Am J Ophthalmol 130:677–679

    Article  PubMed  CAS  Google Scholar 

  4. Haouchine B, Massin P, Gaudric A (2001) Foveal pseudocyst as the first step in macular hole formation: a prospective study by optical coherence tomography. Ophthalmology 108:15–22

    Article  PubMed  CAS  Google Scholar 

  5. Tanner V, Chauhan DS, Jackson TL, Williamson TH (2001) Optical coherence tomography of the vitreoretinal interface in macular hole formation. Br J Ophthalmol 85:1092–1097

    Article  PubMed  CAS  Google Scholar 

  6. Uchino E, Uemura A, Ohba N (2001) Initial stages of posterior vitreous detachment in healthy eyes of older persons evaluated by optical coherence tomography. Arch Ophthalmol 119:1475–1479

    Article  PubMed  CAS  Google Scholar 

  7. Haouchine B, Massin P, Tadayoni R, Erginay A, Gaudric A (2004) Diagnosis of macular pseudoholes and lamellar macular holes by optical coherence tomography. Am J Ophthalmol 138:732–739

    Article  PubMed  Google Scholar 

  8. Ko TH, Fujimoto JG, Duker JS, Paunescu LA, Drexler W, Baumal CR, Puliafito CA, Reichel E, Rogers AH, Schuman JS (2004) Comparison of ultrahigh- and standard resolution optical coherence tomography for imaging macular hole pathology and repair. Ophthalmology 111:2033–2043

    Article  PubMed  Google Scholar 

  9. Witkin AJ, Ko TH, Fujimoto JG, Schuman JS, Baumal CR, Rogers AH, Reichel E, Duker JS (2006) Redefining lamellar holes and the vitreomacular interface: an ultrahigh-resolution optical coherence tomography study. Ophthalmology 113:388–397

    Article  PubMed  Google Scholar 

  10. Bottoni F, Carmassi L, Cigada M, Moschini S, Bergamini F (2008) Diagnosis of macular pseudoholes and lamellar macular holes: is optical coherence tomography the “gold standard”? Br J Ophthalmol 92:635–639

    Article  PubMed  CAS  Google Scholar 

  11. Allen AW Jr, Gass JDM (1976) Contraction of a perifoveal epiretinal membrane simulating a macular hole. Am J Ophthalmol 82:684–691

    PubMed  Google Scholar 

  12. Garretson BR, Pollack JS, Ruby AJ, Drenser K, Williams GA, Sarrafizadeh R (2008) Vitrectomy for a symptomatic lamellar macular hole. Ophthalmology 115:884–886

    Article  PubMed  Google Scholar 

  13. Engler C, Schaal KB, Höh AE, Dithmar S (2008) Surgical treatment of lamellar macular hole. Ophthalmologe 105(9):836–839

    Article  PubMed  CAS  Google Scholar 

  14. Androudi S, Stangos A, Brazitikos PD (2009) Lamellar macular holes: tomographic features and surgical outcome. Am J Ophthalmol 148:420–426

    Article  PubMed  Google Scholar 

  15. Witkin AJ, Castro LC, Reichel E, Rogers AH, Baumal CR, Duker JS (2010) Anatomic and visual outcomes of vitrectomy for lamellar macular holes. Ophthalmic Surg Laser Imag 5:1–7

    Google Scholar 

  16. Michalewska Z, Michalewski J, Odrobina D, Pikulski Z, Cisiecki S, Dziegielewski K, Nawrocki J (2010) Surgical treatment of lamellar macular holes. Graefes Arch Clin Exp Ophthalmol 248:1395–1400

    Article  PubMed  Google Scholar 

  17. Theodossiadis PG, Grigoropoulos VG, Emfietzoglou I, Nikolaidis P, Vergados I, Apostolopoulos M, Theodossiadis GP (2009) Evolution of lamellar macular hole studied by optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 247:13–20

    Article  PubMed  CAS  Google Scholar 

  18. Bottoni F, De Angelis S, Luccarelli S, Cigada M, Staurenghi G (2011) The dynamic healing process of idiopathic macular holes after surgical repair: a Spectral Domain Optical Coherence Tomography study. Invest Ophthalmol Vis Sci 52:4439–4446

    Article  PubMed  Google Scholar 

  19. Grover S, Murthy RK, Brar VS, Chalam KV (2009) Normative data for macular thickness by high-definition Spectral-Domain Optical Coherence Tomography (Spectralis). Am J Ophthalmol 148:266–271

    Article  PubMed  Google Scholar 

  20. Parolini B, Schumann RG, Cereda MG, Haritoglou C, Pertile G (2011) Lamellar macular holes: a clinicopathologic correlation of surgically excised epiretinal membranes. Invest Ophthalmol Vis Sci 52:9074–9083

    Article  PubMed  Google Scholar 

  21. Sramek SJ, Wallow ICH, Stevens TS, Nork TM (1989) Immunostaining of preretinal membranes for actin, fibronectin, and glial fibrillary acidic protein. Ophthalmology 96:835–841

    PubMed  CAS  Google Scholar 

Download references

Financial disclosure(s)

Prof. Staurenghi has received lecture fees from Heidelberg Engineering, Heidelberg, Germany

Author information

Authors and Affiliations

  1. Eye Clinic, Department of Clinical Science “Luigi Sacco”, Sacco Hospital, University of Milan, Via Andrea Verga 8, 20144, Milano, Italy

    Ferdinando Bottoni, Antonio Peroglio Deiro, Andrea Giani, Claudia Orini, Mario Cigada & Giovanni Staurenghi

Authors
  1. Ferdinando Bottoni
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Antonio Peroglio Deiro
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andrea Giani
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Claudia Orini
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mario Cigada
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Giovanni Staurenghi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ferdinando Bottoni.

Additional information

This study had no financial support.

The authors have full control of all primary data and they agree to allow Graefes Archive for Clinical and Experimental Ophthalmology to review their data if requested.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bottoni, F., Deiro, A.P., Giani, A. et al. The natural history of lamellar macular holes: a spectral domain optical coherence tomography study. Graefes Arch Clin Exp Ophthalmol 251, 467–475 (2013). https://doi.org/10.1007/s00417-012-2044-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-012-2044-2

Keywords

Search

Navigation