Original articleMacular structure on optical coherence tomography after lamellar macular hole surgery and its correlation with visual outcome
Section snippets
Methods
The charts of all patients diagnosed with a lamellar hole who had undergone vitrectomy by one of the authors (MSF) were retrospectively evaluated. Patients who had OCT scanning of the macula before and after surgery and who had at least 6 months follow-up were considered for inclusion in the study. Patients who had other ocular pathologies were excluded. The study was approved by our institutional review board and adhered to the tenets of the Declaration of Helsinki.
Preoperatively, all patients
Results
Twelve patients were included in the study; 9 women and 3 men, whose ages ranged between 57 and 82 years. Table 1 shows demographic and pre- and postoperative data.
On OCT, an ERM was preoperatively identified in all cases. These ERMs caused a centrifugal traction, tearing the inner retina and leading to the intraretinal horizontal splits visible in OCT. These splits always occur at the same level: between the outer plexiform layer and the outer nuclear layer (Fig. 1). During surgery, these
Discussion
In recent years, the development of higher definition OCT technology has enabled new insight into the diagnosis and pathogenesis of lamellar macular holes.11 Lamellar holes and macular pseudoholes, which are often difficult to differentiate on clinical examination, have different characteristics on OCT. Lamellar holes have an asymmetric contour and exhibit an intraretinal split, with a separation of the inner from the outer foveal layers. The center of the fovea is often irregular and thinner
Disclosures
The authors have no proprietary or commercial interest in any materials discussed in this article.
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Lamellar Macular Hole: Two Distinct Clinical Entities?
2016, American Journal of OphthalmologyCitation Excerpt :Later, Witkin and associates further refined this description, proposing 4 criteria for the diagnosis of lamellar macular hole with spectral-domain OCT: irregular foveal contour, break in inner fovea, intraretinal split located between the outer plexiform and outer nuclear layers, and intact foveal photoreceptors.1 A number of theories have been proposed to explain the formation of lamellar macular hole, including the union of intraretinal cysts,3 aborted formation of full-thickness macular hole,2,7,8 and centrifugal traction of epiretinal membranes.14 However, none of these hypotheses seem to unify the spectrum of findings observed within the current classification of lamellar macular hole.
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