Natural evolution of idiopathic lamellar macular holes (LMH) and macular pseudoholes (MPH)

Abstract

AbstractPurpose To analyze the natural evolution of idiopathic Lamellar Macular Holes (LMH) and Macular Pseudoholes (MPH), in the long‐term, based on Optical Coherence Tomography (OCT) configuration and in Best Corrected Visual Acuity (BCVA) evolution.Methods We prospectively analyzed 68 eyes (41 right eyes and 27 left eyes) of 61 patients (40 female and 21 male), which were diagnosed as having a MPH or a LMH on OCT examination. The following variables were assessed: BCVA, lens status, and hole size (Diameter ‐D, Residual foveal Thickness –RT, and Perifoveal Thickness ‐PT)(software Caliper of Cirrus OCT), at baseline and final examination. Eyes with significant cataract underwent phacoemulsification.Results The mean follow‐up period was 34.33 ± 15.02 (12‐78) months. Mean BCVA (logMAR notation) in the total group at baseline was 0.40 ± 0.25 and at final was 0.36 ± 0.13 (p=0,082). PAM showed slightly better BCVA than LMH (p<0.05). BCVA improved in those eyes who underwent cataract surgery and remained unchanged in the rest of the eyes. No statistically significant differences regarding D, RT and PT were observed during the follow‐up period (p=0,125).Conclusion Most of idiopathic LMH and MPH do not progress anatomically and do not contribute to a significant diminution of visual acuity during the follow‐up period. We must take into account that the diminishment in visual acuity in most LMH and MPH can be due to the presence of an opacified crystalline and not to the lamellar hole itself.