Surgical outcomes of lamellar macular holes with and without lamellar hole-associated epiretinal proliferation.

Abstract

To report the clinical findings and surgical outcomes of lamellar macular holes (LMHs) with and without lamellar hole-associated epiretinal proliferation (LHEP). A retrospective review was performed of 73 eyes of 73 patients who underwent vitrectomy for LMH. Patients were grouped according to the presence of LHEP on preoperative spectral-domain optical coherence tomography (SD-OCT). Postoperative best-corrected visual acuity (BCVA) and OCT features were compared between LMH patients with and without LHEP. Lamellar hole-associated epiretinal proliferation (LHEP) was found in 15 of 73 eyes with LMHs (20.5%). The mean age was 65.0years. The mean follow-up duration was 21.5months. Preoperatively, eyes with LHEP were characterized by a greater hole diameter (p=0.007), thinner fovea (p=0.002) and greater incidence of outer retinal disruption (p<0.001). Best-corrected visual acuity (BCVA) significantly improved after surgery in eyes without LHEP (p<0.001), but showed no change in eyes with LHEP (p=0.185). Initial BCVA was not different between the two groups; however, final BCVA was better in eyes without LHEP (logarithm of the minimum angle of resolution (logMAR) BCVA, 0.10±0.10 versus 0.33±0.40, p=0.003). OCT evaluations of postoperative foveal configurations showed no difference between the two groups (p=0.171). No case developed a full-thickness macular hole after surgery. There was no visual benefit after surgery in LMH patients with LHEP. Different surgical indications for LMHs may be warranted based on the presence of LHEP-associated pathology.