Compera Denise, Cereda Matteo G, Schumann Ricarda G, Bottoni Ferdinando
Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco," Sacco Hospital, University of Milan, Milan, Italy.
Retin Cases Brief Rep. 2019 Fall;13(4):371-375. doi: 10.1097/ICB.0000000000000605.
To describe evolution and progression of a lamellar macular hole (LMH) with "lamellar hole-associated epiretinal proliferation (LHEP)" using spectral-domain optical coherence tomography and fundus autofluorescence.
Observational case report.
We report on a 63-year-old male patient demonstrating a complete history of LMH development with LHEP occurring during a follow-up period of 8 years. Presenting with a normal foveal contour and attached posterior vitreous at first visit, an LMH developed shortly after incomplete posterior vitreous detachment with vitreopapillary adhesion. On spectral-domain optical coherence tomography images, progression of the LMH including enlargement of the intraretinal cavitation and decrease in the retinal thickness were documented. An increase of LHEP was first documented 6 months after LMH evolution. One month after cataract surgery and 6 years after the first visit, a full-thickness macular hole developed that closed spontaneously after 4 weeks. Localization of LHEP had moved into the foveal defect toward the outer retinal layers. Thereafter, the LMH was stable, and the patient presented with a visual acuity of 20/25.
Proper follow-up time is important for studying eyes with an LMH. Epimacular cell proliferation shows progression over time that appears to be associated with morphologic changes of the LMH including shape of the lamellar defect, amount of LHEP, and contractive properties of epiretinal tissue. The presence of LHEP was documented shortly after posterior vitreous detachment.
使用频域光学相干断层扫描和眼底自发荧光描述伴有“板层裂孔相关视网膜前增殖（LHEP）”的板层黄斑裂孔（LMH）的演变和进展。
观察性病例报告。
我们报告了一名63岁男性患者，其在8年的随访期间呈现了LMH伴LHEP发生的完整发展过程。初诊时中央凹轮廓正常，玻璃体后皮质附着，在不完全玻璃体后脱离伴玻璃体视乳头粘连后不久出现了LMH。在频域光学相干断层扫描图像上，记录了LMH的进展，包括视网膜内空洞扩大和视网膜厚度减小。在LMH演变6个月后首次记录到LHEP增加。白内障手术后1个月以及初诊后6年，出现了全层黄斑裂孔，4周后自发闭合。LHEP的定位已朝着视网膜外层移入黄斑缺损处。此后，LMH稳定，患者视力为20/25。
对于患有LMH的眼睛，适当的随访时间对于研究很重要。黄斑前细胞增殖随时间推移显示出进展，这似乎与LMH的形态学变化有关，包括板层缺损的形状、LHEP的量以及视网膜前组织的收缩特性。玻璃体后脱离后不久记录到了LHEP的存在。
