Pars Plana Vitrectomy For The Treatment Of Tractional And Degenerative Lamellar Macular Holes: Functional and Anatomical Results

Marta S. Figueroa, Andrea Govetto*, David H. Steel, J. Sebag, Gianni Virgili, Jean Pierre Hubschman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)

Abstract

Purpose: Functional and anatomical outcomes of vitrectomy with membrane peeling were compared in tractional lamellar macular holes (LMH)/macular pseudoholes (MPH) versus degenerative LMH. Methods: This multicenter retrospective study enrolled patients with a minimum follow-up of 6 months. The association of spectral domain optical coherence tomography parameters with preoperative and postoperative best-corrected visual acuity was analyzed. Results: Seventy-seven (74.8%) tractional LMH/MPH and 26 (25.2%) degenerative LMH were included. Preoperative best-corrected visual acuity was better in tractional LMH/MPH (0.39 ± 0.2 logarithm of the minimal angle of resolution, 20/50 Snellen equivalent) than degenerative LMH (0.56 ± 0.2 logarithm of the minimal angle of resolution, 20/66 Snellen equivalent; P < 0.001). Premacular membranes were found in all tractional LMH/MPH, whereas LMH-associated epiretinal proliferation (LHEP) was present in all degenerative LMH. Primary anatomical success was achieved in 97/103 eyes (94.2%), with foveal restoration occurring earlier in degenerative LMH (1.6 ± 2.3 vs. 3.3 ± 3.6 months; P = 0.025). Best-corrected visual acuity improved in both tractional LMH/MPH and degenerative LMH (P < 0.001 and P = 0.012, respectively) but was better in tractional LMH/MPH (P = 0.001). Conclusion: The presence of premacular membranes and absence of LMH-associated epiretinal proliferation in all tractional LMH/MPH further distinguishes this from degenerative LMH. Best-corrected visual acuity improved in both subgroups but more so in tractional LMH/MPH. Complete anatomical restoration of foveal microanatomy was rare in degenerative LMH, reflecting significant morphological and pathophysiological differences between the two lesions.

Original languageEnglish
Pages (from-to)2090-2098
Number of pages9
JournalRetina
Volume39
Issue number11
DOIs
Publication statusPublished - 01 Nov 2019
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2019 by Ophthalmic Communications Society, Inc.

Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.

Keywords

  • degenerative lamellar macular hole
  • epiretinal membrane
  • epiretinal proliferation
  • lamellar macular hole
  • macular pseudohole
  • macular pucker
  • pars plana vitrectomy
  • premacular membrane
  • tractional lamellar macular hole

ASJC Scopus subject areas

  • Ophthalmology

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