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The course of lamellar macular holes: assessment by Cirrus and Stratus OCT

Verlauf von Makulaschichtlöchern – Bewertung mit dem Cirrus und Stratus OCT

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Summary

Background

To investigate vitreoretinal relationships and intraretinal changes in the course of lamellar macular holes (LMH).

Material and methods

Cirrus and Stratus optical coherence tomography (OCT) scans of 28 eyes were seen in regular intervals and reviewed in a mean follow-up of 13 months.

Main outcome measures were epiretinal membranes (ERM), posterior vitreous detachment (PVD), vitreopapillary adhesion (VPA), intraretinal cystoid spaces (ICS), a break in the inner segment (IS)/outer segment (OS) layer and in the external limiting membrane (ELM), the widest diameter and central retinal thickness (CRT), distance and near visual acuity (VA).

Results

A total of 22 (79 %) eyes had an ERM, 6 (21 %) eyes showed a PVD. Out of these 5 eyes with ERM underwent pars plana vitrectomy (PPV) for VA deterioration and metamorphopsia. ICS were found in 2 of 28 eyes, a break in the IS/OS layer and a break in the ELM in 4 and 2 eyes, respectively. VPA was found in 10 eyes.

Conclusions

The technical advantages of the Cirrus OCT were irrelevant for the diagnosis, but it was superior to the Stratus OCT in distinguishing between IS/OS, ELM, and ICS. An associated ERM was detected in 79 % of the eyes. VPA was found in 10 patients. Eyes with VPA tended to a higher progression in LMH width. LMHs developed slowly with stable vision, but deteriorated slightly in reading vision. Future prospective investigations are required to study the role of VPA in the course of LMHs and to define guidelines for surgical intervention in patients with clinically relevant visual impairment.

Zusammenfassung

Hintergrund

Die Untersuchung vitreoretinaler Beziehungen und intraretinaler Veränderungen im Verlauf von Makulaschichtlöchern (LMH).

Material und Methoden

Cirrus und Stratus OCT Scans von 28 Augen wurden in regelmäßigen Intervallen gesehen und in einer durchschnittlichen Verlaufsuntersuchung von 13 Monaten begutachtet. Beobachtungsparameter waren epiretinale Membrane (ERM), hintere Glaskörperabhebung (PVD), vitreopapilläre Adhäsion (VPA), intraretinale Cysten (ICS), ein Bruch in der Innensegment- (IS)/Außensegment- (OS) Schicht und in der Membrana limitans externa (ELM), der weiteste Durchmesser und die zentrale Netzhautdicke (CRT), Fern- und Nahvisus (VA).

Resultate

22 (79 %) Augen hatten eine ERM, 6 (21 %) eine PVD. 5 Augen mit ERM wurden wegen Metamorphopsien und Visusverschlechterung mit einer Pars plana Vitrektomie (PPV) behandelt. ICS wurden in 2 von 28 Augen gefunden, ein Bruch in der IS/OS Schicht und in der ELM war in 4 und 2 Augen zu sehen. VPA wurde in 10 Augen gefunden.

Schlussfolgerungen

Die technischen Vorteile des Cirrus OCT waren irrelevant für die Diagnose, es war dem Stratus OCT jedoch überlegen in der Unterscheidung von IS/OS, ELM und ICS. Eine begleitende ERM wurde in 79 % der Augen entdeckt. VPA wurde in 10 Patienten gesehen. Augen mit einer VPA zeigten eine Tendenz zu höherer Progression in der Breite der LMHs. LMHs entwickelten sich langsam mit stabilem Fernvisus, aber verschlechterten sich leicht im Nahvisus. Zukünftige prospektive Studien sind gefragt, um die Rolle der VPA im Verlauf von LMHs zu untersuchen und um Richtlinien zur chirurgischen Intervention bei Patienten mit klinisch relevanter Visusverschlechterung zu definieren.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Ophthalmology, Rudolf Foundation Clinic, Juchgasse 25, 1030, Vienna, Austria

    Shilla Lie MD, Christiane I. Falkner-Radler MD & Susanne Binder MD

  2. The Ludwig Boltzmann Institute for Retinology and Biomicroscopic Laser Surgery, Vienna, Austria

    Shilla Lie MD, Christiane I. Falkner-Radler MD & Susanne Binder MD

Authors
  1. Shilla Lie MD
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  2. Christiane I. Falkner-Radler MD
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  3. Susanne Binder MD
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Correspondence to Shilla Lie MD.

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Lie, S., Falkner-Radler, C. & Binder, S. The course of lamellar macular holes: assessment by Cirrus and Stratus OCT. Spektrum Augenheilkd. 28, 142–147 (2014). https://doi.org/10.1007/s00717-014-0225-6

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  • DOI: https://doi.org/10.1007/s00717-014-0225-6

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