Frisina Rino, Pilotto Elisabetta, Midena Edoardo
Department of Ophthalmology, University of Padua, Padua, Italy,
Department of Ophthalmology, University of Padua, Padua, Italy.
Ophthalmic Res. 2019;61(2):73-82. doi: 10.1159/000494687. Epub 2019 Jan 9.
Lamellar macular hole (LMH) is a vitreoretinal disorder characterized by an irregular foveal contour, a break in the inner fovea, dehiscence of the inner foveal retina from the outer retina, and the absence of a full-thickness foveal defect with intact foveal photoreceptors. The pathogenesis is only partially known. The advent of high-resolution optical coherence tomography has allowed distinguishing between two types of epiretinal membrane (ERM) associated with LMH: a conventional ERM (commonly found in macular pucker) and an atypical ERM (known by varied names: dense, epiretinal proliferation, or degenerative). These two types of ERM not only influence LMH morphology but also differ in cell and collagen composition. It remains unclear if these two types are indeed two distinct clinical entities or rather two stages of the same macular disorder. Studies of the natural evolution of LMH have not fully resolved this issue and also offered variable results. Surgical treatment leads to excellent anatomical and functional outcomes, but not without risks. This review provides a critical summary of the available data on LMH including some new insights.
板层黄斑裂孔（LMH）是一种玻璃体视网膜疾病，其特征为中央凹轮廓不规则、中央凹内层断裂、中央凹内层视网膜与外层视网膜分离，且中央凹光感受器完整，不存在全层中央凹缺损。其发病机制仅部分为人所知。高分辨率光学相干断层扫描技术的出现，使得区分与LMH相关的两种视网膜前膜（ERM）成为可能：一种是传统的ERM（常见于黄斑皱襞），另一种是非典型ERM（有多种名称：致密性、视网膜前增殖或退行性）。这两种类型的ERM不仅影响LMH的形态，而且在细胞和胶原成分上也有所不同。目前尚不清楚这两种类型究竟是两种不同的临床实体，还是同一黄斑疾病的两个阶段。对LMH自然演变的研究尚未完全解决这个问题，且结果也各不相同。手术治疗可带来良好的解剖和功能结果，但并非没有风险。本综述对有关LMH的现有数据进行了批判性总结，包括一些新的见解。
