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

Abstract

Purpose: To report the clinical findings and surgical outcomes of lamellar macular holes (LMHs) with and without lamellar hole-associated epiretinal proliferation (LHEP). Methods: 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. Results: Lamellar hole-associated epiretinal proliferation (LHEP) was found in 15 of 73 eyes with LMHs (20.5%). The mean age was 65.0 years. The mean follow-up duration was 21.5 months. 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. Conclusion: 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.