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Venkatesh R, Pereira A, Jain K, Kumar Yadav N. Structural and Functional Outcomes of Surgery for Lamellar Macular Holes with or without Epimacular Proliferations. JOVR [Internet]. 2022Jan.21 [cited 2024Apr.26];17(1):42–50. Available from: https://knepublishing.com/index.php/JOVR/article/view/10169

https://doi.org/10.18502/jovr.v17i1.10169

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  • Ramesh Venkatesh

    Ramesh Venkatesh

    Department of Retina-Vitreous, Narayana Nethralaya Eye Hospital, Rajaji Nagar, Benguluru, India
    https://orcid.org/0000-0002-4479-9390
  • Arpitha Pereira

    Arpitha Pereira

    Department of Retina-Vitreous, Narayana Nethralaya Eye Hospital, Rajaji Nagar, Benguluru, India
  • Kushagra Jain

    Kushagra Jain

    Department of Retina-Vitreous, Narayana Nethralaya Eye Hospital, Rajaji Nagar, Benguluru, India
  • Naresh Kumar Yadav

    Naresh Kumar Yadav

    Department of Retina-Vitreous, Narayana Nethralaya Eye Hospital, Rajaji Nagar, Benguluru, India

Published Date

  • Jan 21, 2022
This journal is publishing all the articles under Creative Commons Attribution License CC BY 4.0.

Structural and Functional Outcomes of Surgery for Lamellar Macular Holes with or without Epimacular Proliferations

Journal of Ophthalmic and Vision Research (JOVR) / January–March 2022, Volume 17, Issue 1 / Pages 42–50

Abstract

Purpose: To compare the clinical, optical coherence tomography (OCT) features, and surgical outcomes of lamellar macular hole (LMH) depending on the presence of epimacular membrane proliferation (EMPF).


Methods: This retrospective chart review included 112 eyes with LMH. The patients were divided into two groups depending on the presence of EMPF. Group 1 had LMH without EMPF and Group 2 had LMH with EMPF. The best-corrected visual acuity was recorded and OCT scans were obtained.


Results: Lamellar macular hole without and with EMPF was noted in 62 (55%) and 50 (45%) eyes, respectively. The presence of EMPF was associated with lower presenting visual acuity (P = 0.049), wider LMH size at the largest diameter on the horizontal scan (P = 0.001), thinner residual retinal tissue (P =<0.0001), and larger IS-OS defects (P =<0.0001) as compared to the non-EMPF group. Of the 112 eyes, 18 eyes underwent surgery for LMH. Seven eyes had EMPF and the remaining eleven did not have EMPF. The average follow-up time for patients post-surgery and under observation was 16.8 and 24.1 weeks, respectively. A significant improvement in visual acuity was noted in the operated eyes with no EMPF as compared to the eyes with EMPF (P = 0.008). Worsening visual acuity (P = 0.021) was noted in eyes with LMH associated with EMPF which did not undergo surgery. Eyes with LMH and no EMPF, which were not operated on showed a minimal negative change in visual acuity.


Conclusion: LMH with EMPF showed a higher association with accompanying ellipsoid zone disruption. Better anatomical and functional outcomes were achieved in those eyes that underwent surgery for LMH with no presence of EMPF and ellipsoid zone defect.

Keywords:

Epimacular Membrane Proliferation, Full-Thickness Macular Hole, Lamellar Hole Epithelial Proliferation, Lamellar Macular Hole, Surgery

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