Lamellar macular holes in the eyes with pathological myopia

• Published in: Graefe's archive for clinical and experimental ophthalmology Vol. 256; no. 7; pp. 1281 - 1290
• Main Authors: dell’Omo, Roberto, Virgili, Gianni, Bottoni, Ferdinando, Parolini, Barbara, De Turris, Serena, Di Salvatore, Attilo, dell’Omo, Ermanno, Costagliola, Ciro
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.07.2018; Springer Nature B.V
• Subjects: Acuity; Adult; Aged; Aged, 80 and over; Eye; Female; Fluorescein Angiography - methods; Follow-Up Studies; Fovea Centralis - pathology; Fundus Oculi; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Myopia; Myopia, Degenerative - complications; Myopia, Degenerative - diagnosis; Myopia, Degenerative - physiopathology; Ophthalmology; Physical characteristics; Refraction, Ocular; Retina; Retinal Disorders; Retinal Perforations - diagnosis; Retinal Perforations - etiology; Retinoschisis; Retrospective Studies; Tomography, Optical Coherence - methods; Visual Acuity; Blue fundus autofluorescence; Optical coherence tomography; Epiretinal membrane; Lamellar hole-associated epiretinal proliferation; Pathological myopia; Lamellar macular holes
• ISSN: 0721-832X; 1435-702X
• DOI: 10.1007/s00417-018-3995-8

Purpose To study the natural history and morphologic characteristics of lamellar macular holes (LMHs) in the eyes with pathological myopia. Methods Retrospective observational case series of 44 eyes of 44 patients examined at a single institutional vitreoretinal practice. The included eyes must present an irregular foveal contour and schitic or cavitated lamellar separation of neurosensory retina on spectral-domain optical coherence tomography (SD-OCT) and an area of increased autofluorescence on blue fundus autofluorescence (B-FAF) to be included. Presence of retinoschisis and posterior staphyloma, posterior vitreous status, changes of logarithm of minimum angle of resolution best-corrected visual acuity (BCVA), and changes of morphologic characteristics were evaluated. Results The mean follow-up period was 50.1 ± 28.9 months; 75% of the enrolled patients were female. At baseline, a standard epiretinal membrane (ERM) was detected in 93.2%, lamellar hole-associated epiretinal proliferation (LHEP) in 75%, and concomitant ERM and LHEP in 68.2% of the eyes, respectively. Visual acuity did not correlate with LMH diameters but correlated with central foveal thickness ( p  < 0.001). During the follow-up, the morphologic and functional parameters studied were relatively stable/improved in 60% of the eyes independently from the associated epiretinal material. Four eyes evolved to full-thickness (FT) MHs whereas spontaneous improvement was observed in five cases. Conclusions LMHs in highly myopic eyes are more prevalent in females, are frequently associated with ERM and LHEP, and show substantial stability of BCVA and the anatomic parameters evaluated with B-FAF and SD-OCT over years-long follow-up.