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Long-term follow-up of lamellar macular holes and pseudoholes over at least 5 years

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

Abstract

Purpose

To assess morphological and functional changes of lamellar macular holes and pseudoholes with or without vitrectomy and membrane peeling with at least 5 years follow-up.

Methods

Retrospective study of 73 eyes with lamellar macular hole (LH, n = 28), macular pseudohole (PH, n = 31), and pseudohole with cleaved edges (cleavedPH, n = 14). Forty-six eyes were merely observed without vitreoretinal intervention (observation group), and 27 eyes underwent vitrectomy with membrane peeling (vitrectomy group). Outcome measures were best corrected visual acuity (BCVA) and morphological retinal parameters evaluated with optical coherence tomography (TD-OCT and SD-OCT).

Results

Mean follow-up was 8.3 years (5–12); mean age was 67 years (46–84). In the observation group, median BCVA (logMAR) at first exam was 0.2 (LH), 0.1 (PH), 0.2 (cleavedPH) and at last exam 0.3 (LH, p = 0.02), 0.2 (PH), 0.15 (cleavedPH). In the vitrectomy group, median BCVA at first exam was 0.4 (LH), 0.3 (PH), 0.25 (cleavedPH); before vitrectomy BCVA was 0.5 (LH), 0.35 (PH), 0.35 (cleavedPH); and at last exam BCVA increased to 0.3 (LH), 0.2 (PH, p < 0.05), 0.1 (cleavedPH, p < 0.05). At last exam, BCVA of LH was significantly worse compared to PH and cleavedPH. In the observation group, 6 of 29 eyes with PH or cleavedPH showed a spontaneous resolution of the epiretinal membrane with improvement of the foveal contour. Nine of 16 eyes with LH and 2/20 eyes with PH presented lamellar hole-associated epiretinal proliferation (LHEP) in SD-OCT.

Conclusions

LH, PH, and cleavedPH are often stable over a very long time. LH tends to worse visual function compared to PH and cleavedPH. A spontaneous separation of epiretinal membranes in the long-term is not uncommon. Vitreoretinal intervention should be considered in cases with significant visual loss or functional and morphological progression.

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References

  1. Duker JS, Kaiser PK, Binder S et al (2013) The international vitreomacular traction study group classification of vitreomacular adhesion, traction, and macular hole. Ophthalmology 120:2611–2619

    Article  PubMed  Google Scholar 

  2. Gaudric A, Aloulou Y, Tadayoni R, Massin P (2013) Macular pseudoholes with lamellar cleavage of their edge remain pseudoholes. Am J Ophthalmol 155:733–742

    Article  PubMed  Google Scholar 

  3. Figueroa MS, Noval S, Contreras I (2011) Macular structure on optical coherence tomography after lamellar macular hole surgery and its correlation with visual outcome. Can J Ophthalmol 46:491–497

    Article  PubMed  Google Scholar 

  4. Pang CE, Spaide RF, Freund KB (2015) Comparing functional and morphologic characteristics of lamellar macular holes with and without lamellar hole-associated epiretinal proliferation. Retina 35:720–726

    Article  PubMed  Google Scholar 

  5. García-Fernández M, Navarro JC, Sanz AF-V, Castaño CG (2012) Long-term evolution of idiopathic lamellar macular holes and macular pseudoholes. Can J Ophthalmol 47:442–447

    Article  PubMed  Google Scholar 

  6. Witkin AJ, Ko TH, Fujimoto JG et al (2006) Redefining lamellar holes and the vitreomacular interface: an ultrahigh-resolution optical coherence tomography study. Ophthalmology 113:388–397

    Article  PubMed  PubMed Central  Google Scholar 

  7. dell’Omo R, Virgili G, Rizzo S et al (2017) Role of lamellar hole-associated epiretinal proliferation in lamellar macular holes. Am J Ophthalmol 175:16–29

    Article  PubMed  Google Scholar 

  8. Pang CE, Spaide RF, Freund KB (2014) Epiretinal proliferation seen in association with lamellar macular holes: a distinct clinical entity. Retina 34:1513–1523

    Article  PubMed  Google Scholar 

  9. Chen JC, Lee LR (2008) Clinical spectrum of lamellar macular defects including pseudoholes and pseudocysts defined by optical coherence tomography. Br J Ophthalmol 92:1342–1346

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  10. Michalewski J, Michalewska Z, Dzięgielewski K, Nawrocki J (2011) Evolution from macular pseudohole to lamellar macular hole—spectral domain OCT study. Graefes Arch Clin Exp Ophthalmol 249:175–178

    Article  PubMed  Google Scholar 

  11. Theodossiadis PG, Grigoropoulos VG, Emfietzoglou I et al (2012) Spontaneous closure of lamellar macular holes studied by optical coherence tomography. Acta Ophthalmol 90:96–98

    Article  PubMed  Google Scholar 

  12. Compera D, Schumann RG, Cereda MG et al (2017) Progression of lamellar hole-associated epiretinal proliferation and retinal changes during long-term follow-up. Br J Ophthalmol. https://doi.org/10.1136/bjophthalmol-2016-310128

  13. Govetto A, Dacquay Y, Farajzadeh M et al (2016) Lamellar macular hole: two distinct clinical entities? Am J Ophthalmol 164:99–109

    Article  PubMed  Google Scholar 

  14. Lai T-T, Chen S-N, Yang C-M (2016) Epiretinal proliferation in lamellar macular holes and full-thickness macular holes: clinical and surgical findings. Graefes Arch Clin Exp Ophthalmol 254:629–638

    Article  PubMed  Google Scholar 

  15. Compera D, Entchev E, Haritoglou C et al (2015) Lamellar hole-associated epiretinal proliferation in comparison to epiretinal membranes of macular pseudoholes. Am J Ophthalmol 160:373–384

    Article  PubMed  Google Scholar 

  16. Pang CE, Maberley DA, Freund KB et al (2016) Lamellar hole-associated epiretinal proliferation: a clinicopathologic correlation. Retina 36:1408–1412

    Article  PubMed  CAS  Google Scholar 

  17. Schumann RG, Compera D, Schaumberger MM et al (2015) Epiretinal membrane characteristics correlate with photoreceptor layer defects in lamellar macular holes and macular pseudoholes. Retina 35:727–735

    Article  PubMed  Google Scholar 

  18. Theodossiadis PG, Grigoropoulos VG, Emfietzoglou I et al (2009) Evolution of lamellar macular hole studied by optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 247:13–20

    Article  PubMed  CAS  Google Scholar 

  19. Ko J, Kim GA, Lee SC et al (2016) Surgical outcomes of lamellar macular holes with and without lamellar hole-associated epiretinal proliferation. Acta Ophthalmol 95(3):e221–e226. https://doi.org/10.1111/aos.13245

    Article  PubMed  Google Scholar 

  20. Lee SJ, Jang SY, Moon D et al (2012) Long-term surgical outcomes after vitrectomy for symptomatic lamellar macular holes. Retina 32:1743–1748

    Article  PubMed  Google Scholar 

  21. Bottoni F, Deiro AP, Giani A et al (2013) The natural history of lamellar macular holes: a spectral domain optical coherence tomography study. Graefes Arch Clin Exp Ophthalmol 251:467–475

    Article  PubMed  Google Scholar 

  22. Meyer CH, Rodrigues EB, Mennel S et al (2004) Spontaneous separation of epiretinal membrane in young subjects: personal observations and review of the literature. Graefes Arch Clin Exp Ophthalmol 242:977–985

    Article  PubMed  Google Scholar 

  23. Nomoto H, Matsumoto C, Arimura E et al (2013) Quantification of changes in metamorphopsia and retinal contraction in eyes with spontaneous separation of idiopathic epiretinal membrane. Eye Lond Engl 27:924–930

    CAS  Google Scholar 

  24. Andreev AN, Bushuev AV, Svetozarskiy SN (2016) A case of secondary epiretinal membrane spontaneous release. Case Rep Ophthalmol Med 2016:4925763. https://doi.org/10.1155/2016/4925763

    Article  PubMed  PubMed Central  Google Scholar 

  25. Yang HS, Hong JW, Kim YJ et al (2014) Characteristics of spontaneous idiopathic epiretinal membrane separation in spectral domain optical coherence tomography. Retina 34:2079–2087

    Article  PubMed  CAS  Google Scholar 

  26. Morel C, Ameline B, Guiberteau B, Laroche L (2000) Spontaneously favorable course of an epiretinal membrane. J Fr Ophtalmol 23:897–900

    PubMed  CAS  Google Scholar 

  27. Schadlu R, Apte RS (2007) Spontaneous resolution of an inflammation-associated epiretinal membrane with previously documented posterior vitreous detachment. Br J Ophthalmol 91:1252–1253

    Article  PubMed  PubMed Central  Google Scholar 

  28. Kolomeyer AM, Schwartz DM (2013) Spontaneous epiretinal membrane separation. Oman J Ophthalmol 6:56–57

    Article  PubMed  PubMed Central  Google Scholar 

  29. Greven CM, Slusher MM, Weaver RG (1988) Epiretinal membrane release and posterior vitreous detachment. Ophthalmology 95:902–905

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

We thank Jürgen Hedderich from the Institute of Medical Informatics and Statistics, University Medical Center Schleswig-Holstein, Kiel, Germany for his valuable help with the statistical calculations.

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Authors and Affiliations

  1. Department of Ophthalmology, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, building 25, 24105, Kiel, Germany

    K. Purtskhvanidze, L. Balken, T. Hamann, L. Wöster, C. von der Burchard, J. Roider & Felix Treumer

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  1. K. Purtskhvanidze
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  2. L. Balken
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  3. T. Hamann
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  4. L. Wöster
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  5. C. von der Burchard
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  6. J. Roider
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  7. Felix Treumer
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Correspondence to Felix Treumer.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (ethics committee of Christian-Albrechts-University Kiel) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Purtskhvanidze, K., Balken, L., Hamann, T. et al. Long-term follow-up of lamellar macular holes and pseudoholes over at least 5 years. Graefes Arch Clin Exp Ophthalmol 256, 1067–1078 (2018). https://doi.org/10.1007/s00417-018-3972-2

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  • DOI: https://doi.org/10.1007/s00417-018-3972-2

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