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

  • K. Purtskhvanidze
  • L. Balken
  • T. Hamann
  • L. Wöster
  • C. von der Burchard
  • J. Roider
  • Felix Treumer
Retinal Disorders
  • 205 Downloads

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.

Keywords

Lamellar macular hole Macular pseudohole Vitrectomy Membrane peeling Optical coherence tomography 

Notes

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.

Compliance with ethical standards

Conflict of interest

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.

Informed consent

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

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of OphthalmologyUniversity Medical Center Schleswig-HolsteinKielGermany

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