Abstract
Purpose To analyze clinical parameters of two subtypes of lamellar macular hole (LMH): degenerative and tractional. Methods This retrospective chart review study included patients monitored for more than 6 months after the initial diagnosis of LMH from January 2011 to January 2018. LMH was classified in two subtypes: degenerative and tractional. The following parameters between both subtypes were assessed: central subfield thickness (CST), maximum inner diameter (MID), maximum outer diameter (MOD), MID/MOD ratio, inner and outer segment (IS/OS) junction disruption, residual retinal thickness (RRT), subfoveal choroidal thickness (SFCT), best-corrected visual acuity (BCVA), anatomical progression rate, and percentage of patients undergoing surgery. Results This study included 51 eyes with a mean follow-up period of 18.94 months: 33 eyes with tractional LMH and 18 eyes with degenerative LMH. MID was not significantly different between both subtypes but MOD was significantly greater in tractional LMH than degenerative types (tractional, 1131.6 μm; degenerative, 708.9 μm; p < 0.001). The MID were significantly increased in degenerative eyes, while the tractional eyes featured a significant increase in MOD. BCVA was not significantly different between both subtypes at baseline and the last follow-up. Epiretinal membrane presence was significantly different between the two subtypes (tractional, 96.9%; degenerative, 22.2%; p < 0.001). Ellipsoid defect and rate of receiving surgery were not significantly different between both subtypes. The anatomical progression rate in tractional eyes (81.8%) was significantly higher than that of degenerative LMH (27.7%) (p = 0.010). The SFCT was correlated to anatomical progression in the tractional LMH (correlation coefficient = 0.351, p = 0.049) but not in the degenerative LMH. During the follow-up period, 4 eyes (22.2%) of the degenerative LMH and 11 eyes (33.3%) of the tractional LMH underwent surgery. Conclusions We found that greater SFCT at baseline was correlated to anatomical progression of tractional LMH. Therefore, it is expected that SFCT could be used as a biomarker to predict anatomical progression in tractional LMH.
Highlights
Lamellar macular hole (LMH) is a partial-thickness macular defect with an irregular foveal contour and intraretinal splitting [1]
Eighteen and thirty-three eyes were classified into the degenerative and tractional LMH, respectively. e mean age of the patients in the tractional and degenerative LMH was similar: 65.32 ± 11.72 and 68.72 ± 8.18 years, respectively (p 0.491). e sex ratio was significantly different between the two subtypes. e tractional LMH featured more women than did the degenerative (p < 0.001). e maximum inner diameter (MID)/maximum outer diameter (MOD) ratio and presence of epiretinal membrane (ERM) were higher in the tractional type than in the degenerative type (MID/MOD ratio: tractional LMH (63.6%) and degenerative (11.1%), p < 0.001; presence of ERM: tractional LMH (96.9%) and degenerative (22.2%), p < 0.001)
We assumed that the anatomical progression was related to tractional force and vitreomacular traction (VMT) and that the greater subfoveal choroidal thickness (SFCT) might be caused by the greater tractional force and VMT
Summary
Clinical Characteristics of Lamellar Macular Hole Subtypes: Degenerative and Tractional. To analyze clinical parameters of two subtypes of lamellar macular hole (LMH): degenerative and tractional. MID was not significantly different between both subtypes but MOD was significantly greater in tractional LMH than degenerative types (tractional, 1131.6 μm; degenerative, 708.9 μm; p < 0.001). BCVA was not significantly different between both subtypes at baseline and the last follow-up. Ellipsoid defect and rate of receiving surgery were not significantly different between both subtypes. E anatomical progression rate in tractional eyes (81.8%) was significantly higher than that of degenerative LMH (27.7%) (p 0.010). E SFCT was correlated to anatomical progression in the tractional LMH (correlation coefficient 0.351, p 0.049) but not in the degenerative LMH. We found that greater SFCT at baseline was correlated to anatomical progression of tractional LMH. We found that greater SFCT at baseline was correlated to anatomical progression of tractional LMH. erefore, it is expected that SFCT could be used as a biomarker to predict anatomical progression in tractional LMH
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