Long-term follow-up of fellow eye in patients with lamellar macular hole

  • Ugo NavaEmail author
  • Matteo Giuseppe Cereda
  • Ferdinando Bottoni
  • Chiara Preziosa
  • Marco Pellegrini
  • Andrea Giani
  • Giovanni Staurenghi
Retinal Disorders



To evaluate macular changes in fellow eyes of patients diagnosed with lamellar macular hole (LMH) using spectral-domain optical coherence tomography (SD-OCT) and blue fundus autofluorescence (B-FAF).


Fellow eyes of patients diagnosed with a LMH were retrospectively evaluated on OCT. Best-corrected visual acuity (BCVA) and central foveal thickness (CFT) were recorded. Corresponding B-FAF images, vitreo-macular relations, and type of epiretinal membranes (ERMs) were also examined.


Thirty-five patients were included. At baseline, six fellow eyes (17%) showed a normal foveal profile, 26 (74%) had a tractional ERM, and three cases (9%) revealed a bilateral LMH, one of them with a lamellar hole-associated epiretinal proliferation (LHEP). A posterior vitreous detachment (PVD) was present in 29 patients (83%), four (11%) had only a vitreo-papillary adhesion (VPA), and two (6%) had both vitreo-macular adhesion (VMA) and VPA. After a mean follow-up of 4.6 ± 1.9 years, one eye (3%) developed a vitreous detachment from the macula with persistent VPA, and one developed a PVD from a VPA with subsequent ERM formation.

BCVA and mean CFT remained stable in 35 eyes (100%). Likewise, no B-FAF signal variations were detected. One patient developed a LMH during the 3rd year of follow-up.


Our data suggest that the presence of a LMH in one eye does not increase significantly the risk of developing the same condition in the fellow eye after 4 years. Bilateral condition is uncommon, and an ERM is often detected in the fellow eye. LHEPs were not observed in fellow eyes with foveal integrity, and all LHEPs observed (in main and fellow eyes) were always associated with LMHs; this supports the hypothesis that LHEP is a consequence and not a causative factor for LMHs. The occurrence of a LMH in one fellow eye after 3 years follow-up may suggest that a higher incidence of bilateral disease could develop in a longer time span.


Lamellar macular hole Lamellar macular hole fellow eye Epiretinal proliferation Epiretinal membrane Vitreoretinal interface 


Compliance with ethical standards


No funding was received for this research.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Informed consent

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


  1. 1.
    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(3):388–397CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    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(5):732–739CrossRefPubMedGoogle Scholar
  3. 3.
    Duker JS, Kaiser PK, Binder S et al (2013) The International Vitreomacular Traction Study Group classification of vitreomacular adhesion, traction, and macular hole. Ophthalmology 120:2611–2619CrossRefPubMedGoogle Scholar
  4. 4.
    Gass JDM (1976) Lamellar macular hole: a complication of cystoid macular edema after cataract extraction. Arch Ophthalmol 94(5):793–800CrossRefPubMedGoogle Scholar
  5. 5.
    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(6):744–751CrossRefPubMedGoogle Scholar
  6. 6.
    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(5):677–679CrossRefPubMedGoogle Scholar
  7. 7.
    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(1):15–22CrossRefPubMedGoogle Scholar
  8. 8.
    Bottoni F, Peroglio Deiro A, Giani A, Orini C, Cigada M, Staurenghi G (2013) The natural history of lamellar macular holes: a spectral domain optical coherence tomography study. Graefes Arch Clin Exp Ophthalmol 251(2):467–475CrossRefPubMedGoogle Scholar
  9. 9.
    Govetto A, Dacquay Y, Farajzadeh M et al (2016) Lamellar macular hole: two distinct clinical entities? Am J Ophthalmol 164:99–109CrossRefPubMedGoogle Scholar
  10. 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(5):635–639CrossRefPubMedGoogle Scholar
  11. 11.
    Tanner V, Chauhan DS, Jackson TL, Williamson TH (2001) Optical coherence tomography of the vitreoretinal interface in macular hole formation. Br J Ophthalmol 85:1092–1097CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Ophir A, Fatum S (2009) Cystoid foveal oedema in symptomatic inner lamellar macular holes. Eye 23:1781–1785CrossRefPubMedGoogle Scholar
  13. 13.
    Garretson BR, Pollack JS, Ruby AJ et al (2008) Vitrectomy for a symptomatic lamellar macular hole. Ophthalmology 115:884–886CrossRefPubMedGoogle Scholar
  14. 14.
    Parolini B, Schumann RG, Cereda MG, Haritoglou C, Pertile G (2011) Lamellar macular hole: a clinicopathologic correlation of surgically excised epiretinal membranes. Invest Ophthalmol Vis Sci 52(12):9074–9083CrossRefPubMedGoogle Scholar
  15. 15.
    Romano MR, Vallejo-Garcia JL, Camesasca FI, Vinciguerra P, Costagliola C (2012) Vitreo-papillary adhesion as a prognostic factor in pseudo- and lamellar macular holes. Eye 26:810–815CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Pang CE, Spaide RF, Freund KB (2014) Epiretinal proliferation seen in association with lamellar macular holes: a distinct clinical entity. Retina 34(8):1513–1523CrossRefPubMedGoogle Scholar
  17. 17.
    Pang CE, Spaide RF, Freund KB (2015) Comparing functional and morphological characteristics of lamellar holes with and without lamellar hole-associated epiretinal proliferation. Retina 35:720–726CrossRefPubMedGoogle Scholar
  18. 18.
    Engler C, Schaal KB, Höh AE, Dithmar S (2008) Surgical treatment of lamellar macular hole. Ophthalmologe 105(9):836–839CrossRefPubMedGoogle Scholar
  19. 19.
    Androudi S, Stangos A, Brazitikos PD (2009) Lamellar macular holes: tomographic features and surgical outcome. Am J Ophthalmol 148(3):420–426CrossRefPubMedGoogle Scholar
  20. 20.
    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 Imaging 5:1–7Google Scholar
  21. 21.
    Mojana F, Kozak I, Oster SF et al (2010) Observations by spectral-domain optical coherence tomography combined with simultaneous scanning laser ophthalmoscopy: imaging of the vitreous. Am J Ophthalmol 149:641–650CrossRefPubMedGoogle Scholar
  22. 22.
    Meuer SM, Myers CE, Klein BE et al (2015) The epidemiology of vitreoretinal interface abnormalities as detected by spectral-domain optical coherence tomography: the Beaver Dam Eye Study. Ophthalmology 122(4):787–795CrossRefPubMedGoogle Scholar
  23. 23.
    Mitchell P, Smith W, Chey T, Wang JJ, Chang A (1997) Prevalence and associations of epiretinal membranes. The Blue Mountains Eye Study, Australia. Ophthalmology 104(6):1033–1040CrossRefPubMedGoogle Scholar
  24. 24.
    Sebag J (2015) The vitreoretinal interface and its role in the pathogenesis of vitreomaculopathies. Ophthalmologe 112(1):10–19CrossRefPubMedGoogle Scholar
  25. 25.
    Bringmann A, Wiedemann P (2009) Involvement of Muller glial cells in epiretinal membrane formation. Graefes Arch Clin Exp Ophthalmol 247:865–883CrossRefPubMedGoogle Scholar
  26. 26.
    Allen AW Jr, Gass JDM (1976) Contraction of a perifoveal epiretinal membrane simulating a macular hole. Am J Ophthalmol 82:684–691CrossRefPubMedGoogle Scholar
  27. 27.
    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(2):373–384CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Ugo Nava
    • 1
    Email author
  • Matteo Giuseppe Cereda
    • 1
  • Ferdinando Bottoni
    • 1
  • Chiara Preziosa
    • 1
  • Marco Pellegrini
    • 1
  • Andrea Giani
    • 1
  • Giovanni Staurenghi
    • 1
  1. 1.Eye Clinic, Department of Biomedical and Clinical Science “Luigi Sacco”Sacco Hospital, University of MilanMilanoItaly

Personalised recommendations