Abstract

BackgroundGiven the two different kinds of epiretinal membranes, this study aimed to compare both the structural and functional outcomes of lamellar macular holes with and without lamellar hole-associated epiretinal proliferation (LHEP) after surgery.MethodPublications up to July 2020 that compared the surgical outcomes of lamellar macular hole with and without LHEP were included. Forest plots were created by using a weighted summary of proportion meta-analysis. Fixed or random effects models were used on the basis of I2 heterogeneity estimates. Meanwhile, to evaluate the stability of the meta-analysis, a sensitivity analysis was carried out.ResultsEight pertinent publications that contained a total of 176 eyes without LHEP and 173 eyes with LHEP were included. They were all retrospective studies and had a follow-up of at least 6 months. In all studies, the preoperative best corrected visual acuity showed no significant differences between the two groups, and the visual acuity improved in both groups after surgery. The pooled result for the improved best corrected visual acuity was 0.18 (95% confidence interval (CI), 0.10 to 0.26; P < 0.01) between the with and without LHEP groups. The restored ellipsoid zone odds ratio was 0.80 (95% CI, 0.26 to 2.44; P = 0.69) for the group with LHEP compared to the group without LHEP.ConclusionPatients without LHEP had better postoperative visual acuity than patients with LHEP. No significant difference in restored ellipsoid zone was found between the two groups.

Highlights

  • Given the two different kinds of epiretinal membranes, this study aimed to compare both the structural and functional outcomes of lamellar macular holes with and without lamellar hole-associated epiretinal proliferation (LHEP) after surgery

  • The preoperative best corrected visual acuity showed no significant differences between the two groups, and the visual acuity improved in both groups after surgery

  • The restored ellipsoid zone odds ratio was 0.80 for the group with LHEP compared to the group without LHEP

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Summary

Introduction

Given the two different kinds of epiretinal membranes, this study aimed to compare both the structural and functional outcomes of lamellar macular holes with and without lamellar hole-associated epiretinal proliferation (LHEP) after surgery. Lamellar macular holes (LMHs), first described in biomicroscopic and angiographic findings by Gass in a case report, is a partial-thickness loss of foveal tissue [1]. The formation of LMHs is attributable to cystoid macular oedema, contraction of the perifoveal epiretinal membrane and vitreous traction [2]. Witkin et al. The development of ultrahigh-resolution optical coherence tomography (UHR-OCT) has contributed to revealing more microscopic structures of LMHs. UHROCT has allowed visualization of the trapped vitreous or posterior hyaloid, termed epiretinal membranes (ERMs), in most LMH cases. Two types of ERM, tractional ERM (T ERM) and lamellar hole-associated epiretinal proliferation (LHEP), are known as thick ERMs and dense

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