Natural course of lamellar macular holes

Close metadata

PURPOSE

To study natural course of LMH and to develop criteria of their progression.

MATERIAL AND METHODS

The study analyses retrospective data of patients with LMH observed in S. Fyodorov Eye Microsurgery Federal State Institution from 2013 to 2018 who were examined by optical coherence tomography (OCT) at least 2 times with an interval between the initial and last examinations of at least 6 months. The examinations were carried out to evaluate the types of LMH and epiretinal membrane, the ellipsoid zone of photoreceptors and vitreoretinal interface, as well as calculate the changes in the quantitative parameters of the LMH.

RESULTS

One hundred and three patients with LMH were identified; data of 65 patients (65 eyes) was studied in detail. The follow-up lasted 20.5±12.9 months on average. Statistically substantiated criteria for the progression of tractional and degenerative LMH were developed, taking into account the OCT changes most significant for each type of LMH. According to the proposed criteria, signs of marked progression were found in 2 (5.3%) of 38 patients with tractional and 4 (14.8%) of 27 patients with degenerative LMH. Moderate progression was detected in 2 (5.3%) patients with tractional and 2 (7.4%) patients with degenerative LMH. In two patients who were not included in the groups for calculating the criteria for progression, the formation of a full-thickness macular hole has occurred.

CONCLUSION

One of the variants of the natural course of LMH can be its progression up to transition into a full-thickness macular hole. The proposed statistically substantiated criteria allows identifying dangerous progression of LMH, which should be taken into account when determining the treatment tactics.

Keywords:

optical coherence tomography

lamellar macular hole

degenerative

tractional

natural history

progression criteria

epiretinal membrane

Authors:

Shpak A.A.

S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery»

Shkvorchenko D.O.

S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery»

Vedernikova O.Yu.

S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery»

Shahabutdinova P.M.

S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery»

Received:

16.05.2019

Accepted:

10.07.2019

List of references:

Witkin AJ, Ko TH, Fujimoto JG, et al. Redefining lamellar holes and the vitreomacular interface: an ultrahigh-resolution optical coherence tomography study. Ophthalmology. 2006;113:388-397. https://doi.org/10.1016/j.ophtha.2005.10.047
Duker JS, Kaiser PK, Binder S, et al. The International Vitreomacular Traction Study Group classification of vitreomacular adhesion, traction, and macular hole. Ophthalmology. 2013;120:2611-2619. https://doi.org/10.1016/j.ophtha.2013.07.042
Meuer SM, Myers CE, Klein BE, Swift MK, Huang Y, Gangaputra S, Pak JW, Danis R.P, Klein R. The epidemiology of vitreoretinal interface abnormalities as detected by spectral-domain optical coherence tomography: the Beaver Dam Eye Study. Ophthalmology. 2015;122(4):787-795. https://doi.org/10.1016/j.ophtha.2014.10.014
Liesenborghs I, De Clerck EEB, Berendschot TTJM, Goezinne F, Schram MT, Henry RMA, Stehouwer CDA, Webers CAB, Schouten JSAG. Prevalence of optical coherence tomography detected vitreomacular interface disorders: the Maastricht Study. Acta Ophthalmol. 2018;96(7):729-736. https://doi.org/10.1111/aos.13671
Govetto A, Dacquay Y, Farajzadeh M, et al. Lamellar macular hole: two distinct clinical entities? Am J Ophthalmol. 2016;164:99-109. https://doi.org/10.1016/j.ajo.2016.02.008
Sanisoglu H, Elbay A, Sevim S, et al. Surgical therapy versus observation for lamellar macular hole: a retrospective comparison study. Clin Ophthalmol. 2013;7:1843-1848. https://doi.org/10.2147/OPTH.S46283
Sun JP, Chen SN, Chuang CC, et al. Surgical treatment of lamellar macular hole secondary to epiretinal membrane. Graefes Arch Clin Exp Ophthalmol. 2013;251(12):2681-2688. https://doi.org/10.1007/s00417-013-2364-x
Lai TT, Chen SN, Yang CM. Epiretinal proliferation in lamellar macular holes and full-thickness macular holes: clinical and surgical findings. Graefes Arch Clin Exp Ophthalmol. 2016;254(4):629-638. https://doi.org/10.1007/s00417-015-3133-9
Shkvorchenko DO, Shpak AA, Rusanovskaya AV, et al. Khirurgicheskoye lecheniye epiretinal’nogo fibroza s chastichnym foveolyarnym defektom setchatki. In: «MAKULA-2016»: VII Vserossiyskiy seminar — «kruglyy stol». Rostov-on-Don. 2016. Accessed 15.05.2019. (In Russ.). https://elibrary.ru/item.asp?id=27457546
Altynbaev WR. Choice of surgical treatment technique of epiretinal membrane, complicated by macular lamellar tear. Tochka zreniya. Vostok—Zapad. 2017;(2):112-113. Accessed 15.05.2019. (In Russ.). https://eyepress.ru/article.aspx?24137
Vedernikova OYu, Shkvorchenko DO, Sharafetdinov IKh, Krupina EA. Nash pervyy opyt khirurgicheskogo lecheniya lamellyarnykh makulyarnykh razryvov s primeneniyem bogatoy trombotsitami plazmy krovi. Sovremennyye tekhnologii v oftal’mologii. 2017;(4):41-45. Accessed 15.05.19. (In Russ.). https://eyepress.ru/article.aspx?24719
Bayborodov YaV, Zhogolev KS, Balashevich LI, et al. A retrospective analysis of the results of microinvasive posterior vitrectomy in the surgical treatment of non-full thickness macular holes. Oftal’mologiya. 2018;15(2):239-245. (In Russ.). https://doi.org/10.18008/1816-5095-2018-2S-239-245
Theodossiadis PG, Grigoropoulos VG, Emfietzoglou I, et al. Evolution of lamellar macular hole studied by optical coherence tomography. Graefes Arch Clin Exp Ophthalmol. 2009;247(1):13-20. https://doi.org/10.1007/s00417-008-0927-z
Bottoni F, Deiro AP, Giani A, et al. The natural history of lamellar macular holes: a spectral domain optical coherence tomography study. Graefes Arch Clin Exp Ophthalmol. 2013;251(2):467-475. https://doi.org/10.1007/s00417-012-2044-2
Pang CE, Spaide RF, Freund KB. Comparing functional and morphologic characteristics of lamellar macular holes with and without lamellar hole-associated epiretinal proliferation. Retina. 2015;35(4):720-726. https://doi.org/10.1097/IAE.0000000000000390
Chung H, Lee K, Hwang DJ, et al. Prediction of morphologic deterioration in patients with lamellar macular holes. Retina. 2016;36(9):1699-1706. https://doi.org/10.1097/IAE.0000000000000997
Zampedri E, Romanelli F, Semeraro F, et al. Spectral-domain optical coherence tomography ﬁndings in idiopathic lamellar macular hole. Graefes Arch Clin Exp Ophthalmol. 2017;255(4):699-707. https://doi.org/10.1007/s00417-016-3545-1
Dell’Omo R, Virgili G, Rizzo S, et al. Role of lamellar hole-associated epiretinal proliferation in lamellar macular holes. Am J Ophthalmol. 2017;175:16-29. https://doi.org/10.1016/j.ajo.2016.11.007
Compera D, Schumann RG, Cereda MG, et al. Progression of lamellar hole-associated epiretinal proliferation and retinal changes during long-term follow-up. Br J Ophthalmol. 2018;102(1):84-90. https://doi.org/10.1136/bjophthalmol-2016-310128
Compera D, Cereda MG, Schumann RG, Bottoni F. Development and progression of a lamellar macular hole with lamellar hole-associated epiretinal proliferation. Retin Cases Brief Rep. 2017;0:1-5. https://doi.org/10.1097/ICB.0000000000000605
Shpak AA. Opticheskaya kogerentnaya tomografiya: problemy i resheniya. M.: Oftal’mologiya; 2019. (In Russ.).
Gass JD. Idiopathic senile macular hole. Its early stages and pathogenesis. Arch Ophthalmol. 1988;106(5):629-639.
Pang CE, Spaide RF, Freund KB. Epiretinal proliferation seen in association with lamellar macular holes: a distinct clinical entity. Retina. 2014; 34(8):1513-1523. https://doi.org/10.1097/IAE.0000000000000163

Close metadata