Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
College of Medicine, National Taiwan University, Taipei, Taiwan.
PLoS One. 2020 May 6;15(5):e0232852. doi: 10.1371/journal.pone.0232852. eCollection 2020.
To evaluate the clinical characteristics and evolution of lamellar macular hole (LMH) in high myopia and the parameters associated with structural worsening, defined as the development of foveal detachment or full-thickness macular hole.
Patients with high myopia and LMH were retrospectively recruited. The clinical characteristics and various parameters of optical coherence tomography were identified at baseline and during follow-up visits. Cox regression analysis was used to evaluate the hazard ratios for foveal detachment and full-thickness macular hole.
Among 112 eyes (98 patients), 64.3% were female; the mean axial length of all eyes was 29.6 ± 1.9 mm. The 'LMH without retinoschisis' group accounted for 39.3% of the eyes. Forty-two percent developed structural worsening within a median follow-up of 67 months. Multivariable regression on all cases showed elevated tissue inside the LMH (P = 0.003) protected against structural worsening while V-shaped LMH (P = 0.006) predicted it. In the "LMH with retinoschisis group", ellipsoid zone disruption (P = 0.035), and V-shaped LMH (P = 0.014) predicted structural worsening, while elevated tissue inside the LMH (P = 0.028) protected against it. In the "LMH without retinoschisis group", no associated factor was identified.
LMHs in high myopia are unstable, especially those with V-shaped LMH. Elevated tissue inside LMHs have a protective effect against further structural worsening.
评估高度近视性板层黄斑裂孔（LMH）的临床特征和演变，以及与结构恶化相关的参数，结构恶化定义为出现中心凹脱离或全层黄斑裂孔。
回顾性招募高度近视合并 LMH 的患者。在基线和随访期间，确定了患者的临床特征和各种光学相干断层扫描参数。采用 Cox 回归分析评估中心凹脱离和全层黄斑裂孔的风险比。
在 112 只眼中（98 例患者），64.3%为女性；所有眼的平均眼轴长度为 29.6±1.9mm。“无格子样变性的 LMH”组占眼的 39.3%。42%的眼在中位数为 67 个月的随访中出现结构恶化。对所有病例进行多变量回归分析显示，LMH 内的隆起组织（P=0.003）可预防结构恶化，而 V 形 LMH（P=0.006）则预测结构恶化。在“有格子样变性的 LMH 组”中，椭圆体带破坏（P=0.035）和 V 形 LMH（P=0.014）预测结构恶化，而 LMH 内的隆起组织（P=0.028）则可预防结构恶化。在“无格子样变性的 LMH 组”中，未发现相关因素。
高度近视性 LMH 不稳定，尤其是 V 形 LMH。LMH 内的隆起组织对进一步的结构恶化具有保护作用。
