Department of Ophthalmology, Columbia University, New York, New York.
College of Arts and Sciences, Columbia University, New York, New York.
Retina. 2018 Apr;38(4):664-669. doi: 10.1097/IAE.0000000000001591.
To compare the surgical outcome of a lamellar macular hole (LMH) depending on lamellar hole-associated epiretinal proliferation (LHEP) and full-thickness macular hole.
This is a retrospective chart review. Thirty-three patients were enrolled for this study. The patients were divided into three groups depending on the type of macular hole and presence of LHEP. Group 1 had epiretinal membranes with LMH without LHEP, Group 2 had LMH with LHEP, and Group 3 had full-thickness macular hole with LHEP. The best-corrected visual acuity was recorded and optical coherence tomography scans were obtained.
Preoperative best-corrected visual acuity showed no significant difference between groups (P = 0.968). Final visual acuity of Group 1 was better than that of Group 2 (P = 0.009). Group 1 showed less postoperative ellipsoid zone disruption compared with Group 2 (P = 0.010), and the duration of LHEP to surgery had no significant correlation with postoperative visual acuity (P = 0.629).
Lamellar macular hole with LHEP showed poorer visual outcomes compared with those with highly reflective epiretinal membranes. Lamellar macular hole with LHEP showed a greater chance of ellipsoid zone disruption. These findings may explain the wide variability of visual outcomes previously reported after vitrectomy for LMH.
比较板层黄斑孔（LMH）的手术结果，根据板层孔相关的视网膜前膜增殖（LHEP）和全层黄斑孔进行分组。
这是一项回顾性图表研究。共有 33 名患者入组本研究。根据黄斑孔的类型和 LHEP 的存在情况，将患者分为三组。第 1 组为 LMH 合并无 LHEP 的视网膜前膜，第 2 组为 LMH 合并 LHEP，第 3 组为全层黄斑孔合并 LHEP。记录最佳矫正视力，获取光学相干断层扫描图像。
术前最佳矫正视力在各组之间无显著差异（P = 0.968）。第 1 组的最终视力优于第 2 组（P = 0.009）。与第 2 组相比，第 1 组术后椭圆体带破坏较少（P = 0.010），LHEP 至手术的时间与术后视力无显著相关性（P = 0.629）。
与伴有高反射性视网膜前膜的 LHEP 相比，LMH 合并 LHEP 的视力结果较差。LMH 合并 LHEP 发生椭圆体带破坏的可能性更大。这些发现可能解释了之前报道的 LMH 玻璃体切除术后视力结果差异较大的原因。
