Natural History and Surgical Outcomes of Lamellar Macular Holes.

Autor:	Chehaibou I; Ophthalmology Department, Hôpital Fondation Adolphe de Rothschild, Paris, France., Tadayoni R; Ophthalmology Department, Hôpital Fondation Adolphe de Rothschild, Paris, France; Université Paris Cité, AP-HP, Hôpital Lariboisière, Paris, France., Hubschman JP; Retina Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California., Bottoni F; Eye Clinic, Department of Biomedical and Clinical Science 'Luigi Sacco,' Sacco Hospital, University of Milan, Milan, Italy., Caputo G; Ophthalmology Department, Hôpital Fondation Adolphe de Rothschild, Paris, France., Chang S; Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, New York., Dell'Omo R; Department of Medicine and Health Sciences 'Vincenzo Tiberio,' University of Molise, Campobasso, Italy., Figueroa MS; Clinica Baviera, Department of Ophthalmology, Ramon y Cajal University Hospital, University of Alcala de Henares, Madrid, Spain., Gaudric A; Université Paris Cité, AP-HP, Hôpital Lariboisière, Paris, France., Haritoglou C; Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany., Kadonosono K; Department of Ophthalmology and micro-technology, Yokohama City University Medical School, Yokohama, Japan., Leisser C; VIROS-Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Vienna, Austria., Maier M; Klinik und Poliklinik für Augenheilkunde, Technische Universität München, Munich, Germany., Priglinger S; Augenklinik der LMU, Klinikum der Universität München, Munich, Germany., Rizzo S; Department of Ophthalmology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Dipartimento Testa-collo e organi di senso, Università Cattolica del Sacro Cuore, Rome, Italy; Istituto di Neuroscienze, Consiglio Nazionale della Ricerca, Pisa, Italy., Schumann RG; Eye and Vascular Medicine Center, Ludwig-Maximilians-University, Munich, Germany., Sebag J; VMR Institute for Vitreous Macula Retina, Huntington Beach, California; Doheny Eye Institute, UCLA, Pasadena, California; Department of Ophthalmology, David Geffen School of Medicine, UCLA, Los Angeles, California., Stamenkovic M; Eye clinic, University Hospital Zvezdara, Belgrad, Serbia., Veckeneer M; Department of Ophthalmology, ZNA Middelheim Hospital, Antwerp, Belgium., Steel DH; Ophthalmology, Sunderland Eye Infirmary, Sunderland, United Kingdom; Bioscience Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom. Electronic address: david.steel@newcastle.ac.uk.
Jazyk:	angličtina
Zdroj:	Ophthalmology. Retina [Ophthalmol Retina] 2024 Mar; Vol. 8 (3), pp. 210-222. Date of Electronic Publication: 2023 Sep 22.
DOI:	10.1016/j.oret.2023.09.016
Abstrakt:	Purpose: To assess the natural history and surgical outcomes of lamellar macular holes (LMHs). Design: Retrospective and consecutive case series. Subjects: Patients with LMHs from multiple tertiary care centers. Methods: Clinical charts and OCT scans were reviewed. Main Outcome Measures: The visual acuity (VA) changes and the occurrence rate of full-thickness macular hole (FTMH) were studied in both groups. Within the operated group, factors associated with 6-month VA and development of FTMH were explored. Results: One hundred seventy-eight eyes were included, of which 89 were monitored and 89 underwent surgery. In the observation group, the mean VA decreased from 0.25 ± 0.18 to 0.28 ± 0.18 logarithm of the minimum angle of resolution (logMAR; P = 0.13), with 14 eyes (15.7%) that lost ≥ 0.2 logMAR VA, after 45.7 ± 33.3 months. Nine eyes (10.1%) spontaneously developed an FTMH. In the operated group, the mean VA increased from 0.47 ± 0.23 to 0.35 ± 0.25 logMAR at 6 months (P < 0.001) and 0.36 ± 0.28 logMAR (P = 0.001) after 24.1 ± 30.1 months. By multivariate analysis, better baseline VA (P < 0.001), the presence of an epiretinal membrane (P = 0.03), and the peeling of the internal limiting membrane (ILM; P = 0.02), with a greater effect of ILM perihole sparing, were associated with a greater 6-month VA. Perihole epiretinal proliferation sparing was associated with a better postoperative VA by univariate analysis (P = 0.03), but this was not significant by multivariate analysis. Eight eyes (9.0%) developed a postoperative FTMH. Using Cox proportional hazard ratios [HRs], pseudophakia at baseline (HR, 0.06; 95% confidence interval [CI], 0.00-0.75; P = 0.03) and peeling of the ILM (HR, 0.05; 95% CI, 0.01-0.39; P = 0.004) were protective factors, while ellipsoid zone disruption (HR, 10.5; 95% CI, 1.04-105; P = 0.05) was associated with an increased risk of FTMH. Conclusion: Observed eyes with LMH experienced, on average, progressive VA loss. Patients with LMH and altered vision may benefit from surgery. Internal limiting membrane peeling, with perihole ILM sparing, represents a crucial step of the surgery associated with a greater VA and a lower risk of postoperative FTMH. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article. (Copyright © 2023 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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