Lamellar macular holes: monitoring and management strategies

Figures & data

Figure 1 Optical coherence tomography of a tractional lamellar macular hole, characterized by epiretinal membrane with surface wrinkling, sharp intraretinal split, and “schisis-like” appearance.

Figure 2 Degenerative lamellar macular hole identified by round-edged intraretinal cavitation, “foveal bump”, and epiretinal proliferation of medium reflectivity.

Table 1 Studies on natural history of lamellar macular holes

	Year	Eyes (n)	No LHEP	LHEP	Mixed form	Mean follow-up (months)	Baseline BCVA (logMAR)	Last visit BCVA (logMAR)	Baseline CFT (µm)	Last visit CFT (µm)	EZ disruptions (n)
Bottoni et al^Citation10	2012	34	24	10	0	18±10	0.44±0.12	0.46±0.08	180±29	175±21	3
Compera et al^Citation29	2017	76	42	34	0	40.5±26.2	0.30±0.16	0.32±0.21	141±29	131±32	29
dell’Omo et al^Citation23	2018	44	11	3	30	50.1±28.9	0.30±0.25	0.33±0.38	180.2±52.9	NA	11
Michalewska et al^Citation5	2012	45	NA	NA	NA	14±12	0.59 (0.01–1)	NA	156 (46–530)	NA	34
Theodossiadis et al^Citation19	2008	41	NA	NA	NA	37.1	0.92±0.20	0.96±0.20	93.73±20.2	84.12±21.8	NA
Zampedri et al^Citation9	2016	189	117	72	0	12	0.24±0.25	NA	132.7±68	NA	64
Govetto et al^Citation8	2016	102	49	42	11	33.6±21.7	DLMH 0.27±0.20 TLMH 0.13±0.12	DLMH 0.32±0.26 TLMH 0.17±0.19	DLMH 101.1±34 TLMH 140±20.3	DLMH 95.2±36.4 TLMH 139±21.8	46
Pang et al^Citation7	2015	145	83	62	0	27.7±23.3	LHEP 0.51±0.39; no LHEP 0.33±0.31	NA	NA	NA	75
dell’Omo et al^Citation30	2016	84	43	41	0	33.4±19.3	LHEP 0.35±0.28; no LHEP 0.16±0.15	NA	LHEP 163±48; no LHEP 196±36	NA	28

Abbreviations: LHEP, lamellar hole–associated epiretinal proliferation; BCVA, best-corrected visual acuity; logMAR, logarithm of minimum angle of resolution; CFT, central foveal thickness; EZ, ellipsoidal zone; DLMH, degenerative lamellar macular hole; TLMH, tractional lamellar macular hole; NA, not available.

Table 2 Studies describing surgical outcomes of vitrectomy for lamellar macular holes

	Year	Eyes (n)	LHEP	No LHEP	Mixed form	Baseline lens status (phakic vs pseudophakic)	Final lens status (phakic vs pseudophakic)	Vitrectomy technique (gauge/peeling/gas tamponade)	Mean BCVA before (logMAR)	Mean BCVA after (logMAR)	FTMH development
Casparis et al^Citation37	2011	45	NA	NA	NA	32:13	15:30	23 G/ERM + ILM/Air or SF6	0.4	0.13	NA
Androudi et al^Citation38	2009	32	NA	NA	NA	8:12	0:20	25 G/ERM + ILM/SF6	NA	NA	NA
Choi et al^Citation36	2018	22	11	11	NA	13:9	3:19	23 G/ERM + ILM/air	LHEP 0.50±0.25; no LHEP 0.48±0.18	LHEP 0.40±0.29; no LHEP 0.15±0.16	3
Figueroa et al^Citation35	2011	12	NA	NA	NA	9:3	6:6	25 G/ERM + ILM/C3F8	0.34±0.14	0.17±0.04	2
Garreston et al^Citation39	2007	27	NA	NA	NA	NA	NA	20/23/25 G/ERM + ILM/NA	NA	NA	2
Ko et al^Citation43	2016	73	15	58	NA	60:13	5:68	23–25 G/ERM + ILM/C3F8, SF6	LHEP 0.38±0.38; no LHEP 0.30±0.26	LHEP 0.33±0.40; no LHEP 0.10±0.10	0
Lai et al^Citation44	2015	43	19	24	NA	NA	NA	23 G/ERM + ILM/C3F8	LHEP 0.79±0.37; no LHEP 0.72±0.32	LHEP 0.45±0.39; no LHEP 0.43±0.44	NA
Parolini et al^Citation27	2011	19	13	6	NA	11:8	0:19	NA/ERM + ILM/air	LHEP 0.4±0.2; no LHEP 0.4±0.2	LHEP 0.2±0.2; no LHEP 0.2±0.3	3
Coassin et al^Citation28	2018	106	19	9	18	88:18	19:87	23 G/ERM+ILM/air, SF6, C3F8	LHEP 0.61±0.31; no LHEP 0.41±0.19; mixed form 0.46±0.28	LHEP 0.54±0.44; no LHEP 0.25±0.27; mixed form 0.30±0.35	3
Michaeawska et al^Citation32	2010	26	NA	NA	NA	25:1	20:6	20 G/ERM + ILM/none	0.7	0.3	0
Sanisoglu et al^Citation40	2013	40	NA	NA	NA	16:3	11:8	23 G/ERM + ILM/air or SF6	0.54±0.92	0.33±0.54	2

Abbreviations: LHEP, lamellar hole–associated epiretinal proliferation; ERM, epiretinal membrane; ILM, internal limiting membrane; BCVA, best-corrected visual acuity; logMAR, logarithm of minimum angle of resolution; FTMH, full-thickness macular hole; NA, not available.

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