Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei, Taiwan.
Retina. 2018 Jul;38(7):1316-1323. doi: 10.1097/IAE.0000000000001708.
To report findings and surgical outcomes of lamellar macular hole (LMH) or full-thickness macular hole (FTMH) accompanied by lamellar hole-associated epiretinal proliferation (LHEP) in eyes with high myopia (HM).
Consecutive cases of HM with LMH or FTMH containing LHEP were retrospectively reviewed (study group, 43 cases). Cases of HM without LHEP (22) and those of non-HM with LHEP (30) served as Control A and B.
The study group showed larger (928.7 ± 381.9 μm) and deeper (remained base thickness: 79.7 ± 23.7 μm) LMH retinal defect than that in Control A (466.2 ± 179.1 and 99.9 ± 24.9) and B (647.1 ± 346.7 and 99.1 ± 38.1). Lamellar hole-associated epiretinal proliferation in the study group had a higher rate of wide extension (42.3%) and growing along the posterior hyaloid (PH, 53.8%). Patients with LMH who underwent surgery in the study group and Control A showed limited best corrected visual acuity (BCVA) improvement (0-1 and 1-2 ETDRS lines, respectively), while Control B had significant improvement (4-5 lines). For full-thickness macular holes, the study group was the youngest (50.0 ± 11.4) and LHEP was more likely to grow on the posterior hyaloid (23.5%); the postoperative best corrected visual acuity, however, was similar to that in Control A (20/63-20/80).
Lamellar hole-associated epiretinal proliferation in HM tended to be more widespread and adherent to the posterior hyaloid than in eyes without HM. Visual outcomes after LMH repair in eyes with LHEP and HM are less favorable than eyes with LHEP and without HM, but similar to eyes with HM and without LHEP.
报告高度近视(HM)伴层间黄斑孔(LMH)或全层黄斑孔(FTMH)合并层间孔相关视网膜前膜(LHEP)的患者的发现和手术结果。
回顾性分析连续患有 LMH 或 FTMH 合并 LHEP 的 HM 患者(研究组,43 例)。HM 无 LHEP(22 例)和非 HM 合并 LHEP(30 例)患者作为对照 A 和对照 B。
研究组的 LMH 视网膜缺陷较大(928.7 ± 381.9μm)且较深(残余基底厚度:79.7 ± 23.7μm),明显大于对照 A(466.2 ± 179.1μm 和 99.9 ± 24.9μm)和对照 B(647.1 ± 346.7μm 和 99.1 ± 38.1μm)。研究组的 LHEP 更易广泛延伸(42.3%)和沿后玻璃体(PH)生长(53.8%)。研究组和对照 A 中接受 LMH 手术的患者最佳矫正视力(BCVA)改善有限(分别为 0-1 和 1-2 ETDRS 线),而对照 B 则显著改善(4-5 线)。对于全层黄斑孔,研究组年龄最小(50.0 ± 11.4 岁),LHEP 更易沿 PH 生长(23.5%);但术后 BCVA 与对照 A 相似(20/63-20/80)。
HM 伴层间孔相关视网膜前膜比非 HM 眼更广泛且更易与 PH 黏附。合并 LHEP 和 HM 的眼行 LMH 修复后视力结果不如合并 LHEP 但无 HM 的眼,与合并 HM 但无 LHEP 的眼相似。