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

 Jaesang Ko  ;  Gyu Ah Kim  ;  Sung Chul Lee  ;  Jihwan Lee  ;  Hyoung Jun Koh  ;  Sung Soo Kim  ;  Suk Ho Byeon  ;  Christopher Seungkyu Lee 
 ACTA OPHTHALMOLOGICA, Vol.95(3) : 221-226, 2017 
Journal Title
Issue Date
Aged ; Epiretinal Membrane/diagnosis ; Epiretinal Membrane/etiology* ; Epiretinal Membrane/surgery ; Female ; Follow-Up Studies ; Fovea Centralis/pathology* ; Humans ; Male ; Middle Aged ; Retinal Perforations/complications ; Retinal Perforations/diagnosis ; Retinal Perforations/surgery* ; Retrospective Studies ; Tomography, Optical Coherence/methods* ; Treatment Outcome ; Visual Acuity* ; Vitrectomy/methods*
epiretinal membrane ; epiretinal proliferation ; lamellar hole-associated epiretinal proliferation ; lamellar macular hole ; vitrectomy
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.
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1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Jaesang(고재상) ORCID logo https://orcid.org/0000-0002-3011-7213
Koh, Hyoung Jun(고형준) ORCID logo https://orcid.org/0000-0002-5932-8516
Kim, Gyuah(김규아)
Kim, Sung Soo(김성수) ORCID logo https://orcid.org/0000-0002-0574-7993
Byeon, Suk Ho(변석호) ORCID logo https://orcid.org/0000-0001-8101-0830
Lee, Sung Chul(이성철) ORCID logo https://orcid.org/0000-0001-9438-2385
Lee, Christopher Seungkyu(이승규) ORCID logo https://orcid.org/0000-0001-5054-9470
Lee, Ji Hwan(이지환) ORCID logo https://orcid.org/0000-0003-1759-8195
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