dell'Omo Roberto, Filippelli Mariaelena, De Turris Serena, Govetto Andrea, Napolitano Pasquale, Costagliola Ciro
Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Via Francesco De Sanctis 1, Campobasso 86100, Italy.
Eye Clinic, Polytechnic University of Marche, Via Conca 71, Ancona 60121, Italy.
J Ophthalmol. 2021 Jan 30;2021:8820444. doi: 10.1155/2021/8820444. eCollection 2021.
Evolution of imaging techniques has renewed interest in the diagnosis of lamellar macular hole (LMH) and greatly implemented the possibilities of gaining more detailed insights into its pathogenesis. Among noninvasive techniques, optical coherence tomography (OCT) is considered the primary examination modality to study LMHs, given its ability to image foveal structure and its widespread availability. OCT also allows to resolve the epiretinal materials associated with LMH, i.e., tractional epiretinal membranes (ERMs) and epiretinal proliferation (EP). En face OCT reconstructions are useful to confirm the foveal abnormalities shown by the eyes with LMH, whereas OCT angiography may reveal alterations of the size and shape of the foveal avascular zone and alterations of the density of the superficial and deep vascular plexuses. On slit-lamp biomicroscopy or fundus camera examination, LMH appears as a round or oval, reddish lesion at the center of the macula, slightly darker than the surrounding retina. The associated tractional ERM, causing wrinkling and glistening of the retinal surface, is usually readily appreciable, whereas EP is hardly apparent on biomicroscopy or fundus photography since the retina surface appears smooth. When imaged with blue fundus autofluorescence (B-FAF) imaging, LMHs are characterized by an increased autofluorescent signal, the intensity of which does not correlate with the thickness of the residual outer retinal tissue. Green reflectance and blue reflectance (BR) images clearly show the increased reflection and wrinkling of the retinal surface caused by tractional ERM associated with LMH. BR and multicolor imaging enable the visualization of EP associated with LMH in the form of a sharply demarcated dark area and in the form of a yellowish area surrounding the hole, respectively. Scarce data regarding invasive imaging techniques, such as fluorescein angiography, for the study of LMH are available in the literature. The aim of this review is to evaluate the contribution that each imaging modality can provide to study the morphologic characteristics of LMH.
成像技术的发展重新激发了人们对板层黄斑裂孔（LMH）诊断的兴趣，并极大地拓展了更深入了解其发病机制的可能性。在非侵入性技术中，光学相干断层扫描（OCT）因其能够对黄斑结构进行成像且广泛应用，被认为是研究LMH的主要检查方式。OCT还能够分辨与LMH相关的视网膜前物质，即牵引性视网膜前膜（ERM）和视网膜前增殖（EP）。OCT的表面重建有助于确认患有LMH的眼睛所显示的黄斑异常，而OCT血管造影可能会揭示黄斑无血管区大小和形状的改变以及浅表和深部血管丛密度的改变。在裂隙灯生物显微镜检查或眼底照相机检查中，LMH表现为黄斑中心的圆形或椭圆形红色病变，比周围视网膜略暗。通常很容易观察到相关的牵引性ERM，它会导致视网膜表面起皱和反光，而在生物显微镜检查或眼底摄影中，由于视网膜表面看起来光滑，EP很难显现。当用蓝色眼底自发荧光（B-FAF）成像时，LMH的特征是自发荧光信号增强，其强度与残留的外层视网膜组织厚度无关。绿色反射率和蓝色反射率（BR）图像清楚地显示了与LMH相关的牵引性ERM引起的视网膜表面反射增强和起皱。BR和多色成像分别能够以清晰界定的暗区形式和围绕裂孔的淡黄色区域形式显示与LMH相关的EP。关于用于研究LMH的侵入性成像技术，如荧光素血管造影的资料很少。本综述的目的是评估每种成像方式对研究LMH形态特征的贡献。
