[Lamellar macular holes-In the center of vitreomacular interface diseases : Pathophysiology, spontaneous courses and treatment concepts].

Autor: Klaas JE; Augenklinik und Poliklinik, LMU Klinikum, LMU München, Mathildenstr. 8, 80336, München, Deutschland., Lommatzsch A; St. Franziskus Eye Center, Münster, Deutschland., Krohne TU; Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Deutschland., Hattenbach LO; Augenklinik, Klinikum Ludwigshafen, Bremserstr. 79, 67063, Ludwigshafen, Deutschland., Priglinger S; Augenklinik und Poliklinik, LMU Klinikum, LMU München, Mathildenstr. 8, 80336, München, Deutschland. Siegfried.priglinger@med.uni-muenchen.de.
Jazyk: němčina
Zdroj: Die Ophthalmologie [Ophthalmologie] 2024 Jun; Vol. 121 (6), pp. 452-461. Date of Electronic Publication: 2024 Jun 06.
DOI: 10.1007/s00347-024-02054-0
Abstrakt: Background: A lamellar macular hole (LMH) is characterized by a distinct morphologic configuration and can be distinguished from related entities such as macular pseudohole (MPH) and epiretinal membrane with foveoschisis (ERM-FS) by clear morphologic features.
Purpose: Based on current knowledge, the pathophysiologic function of LMH in the spectrum of vitreomacular interface diseases will be described and therapeutic concepts will be presented.
Methods: Current studies are supplemented by case reports to provide a schematic overview of the natural history and therapeutic concepts at the vitreomacular interface.
Results: The LMH is as a retrospective marker for pathologic posterior vitreous detachment in adult patients and may be interpreted as the pathophysiologic center of tractional maculopathies. Various vitreomacular pathologies can result in LMH: a detached vitreomacular traction, a spontaneously closed penetrating macular hole, or an epiretinal membrane with foveoschisis. Pathophysiologically, a degenerative, progressive loss of the architecture of the foveal muller cell cone may be the underlaying mechanism, resulting in the typical undermining of the hole edges and occasionally in a full thickness macular hole. The optimal timing and the appropriate surgical method are the focus of current clinical studies.
Conclusion: The pathophysiology of LMH indicates a smooth transition of tractive maculopathies. These should be prospectively evaluated in order to develop evidence-based treatment strategies for LMH.
(© 2024. The Author(s).)
Databáze: MEDLINE
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