Abstract
BackgroundWe recently reported that lamellar macular hole (LMH) with lamellar hole-associated epiretinal proliferation (LHEP) can be effectively treated by embedding the LHEP into the retinal cleavage to improve foveal contour and visual acuity. Here, we report a case of LMH with LHEP for which we performed embedding of the LHEP combined with internal limiting membrane (ILM) inversion. We then evaluated the effects of this surgery on macular morphology and visual functions.Case presentationA 62-year-old man presented with visual disturbance (20/29) and metamorphopsia in his right eye. B-scan optical coherence tomography (OCT) imaging revealed the presence of both partial-thickness defect of the macula with degenerative retinal cleavage and LHEP at the surface of the retina. En face OCT imaging showed the absence of retinal fold. We performed phacoemulsification with intraocular lens implantation, vitrectomy, embedding of LHEP into the retinal cleavage, and ILM inversion. Three months after the surgery, both foveal contour and visual acuity (20/20) were improved and metamorphopsia was reduced.ConclusionEmbedding of the LHEP combined with ILM inversion may be an effective treatment for LMH with LHEP.
Highlights
We recently reported that lamellar macular hole (LMH) with lamellar hole-associated epiretinal proliferation (LHEP) can be effectively treated by embedding the LHEP into the retinal cleavage to improve foveal contour and visual acuity
Embedding of the LHEP combined with internal limiting membrane (ILM) inversion may be an effective treatment for LMH with LHEP
Shiode et al BMC Ophthalmology (2018) 18:257 degenerative LMH does not result in improved visual acuity or macular contour, and, this surgery does result in an increased risk of macular hole formation [10–12]
Summary
We recently reported that lamellar macular hole (LMH) with lamellar hole-associated epiretinal proliferation (LHEP) can be effectively treated by embedding the LHEP into the retinal cleavage to improve foveal contour and visual acuity. Observations during surgery for degenerative LMH have shown that that LHEP, unlike typical ERM, connects to the retina at the edge of the foveal aperture of the LMH [14]. These findings indicate that LHEP is composed of one of the major retinal glial cells, Müller cells, which have proliferated and migrated on the retinal surface with macular pigment [14]
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