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HEESEONG YOON, Sun Young Lee, Woo Seok Lee, Kyung Hun Lee; Surgical Treatment of Lamellar Macular Hole Associated with Epiretinal Membrane and Prognostic Factors for Surgical Outcome. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3851.
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To evaluate long-term surgical outcome and prognostic factors after vitrectomy for symptomatic lamellar macular hole (LMH) associated with epiretinal membrane (ERM).
Medical records of symptomatic 15 eyes of 15 patients diagnosed with LMH associated with ERM were reviewed retrospectively. In all eyes, pars plana vitrectomy and removal of ERM and internal limiting membrane (ILM) by one author (Y.H.S) were undergone and post-operative follow-up period was more than 6 months. Best-corrected visual acuity (BCVA) and spectral-domain optical coherence tomographic (SD-OCT) images of macula were assessed before and after surgery. Preoperative BCVA, SD-OCT features and electro retinal response in the foveal and the perifoveal area using multifocal-electroretinogram (m-ERG) were analyzed for predicting surgical outcomes.
Pre-operative BCVA was ranged from 8/200 to 20/32. Both anatomical closure of LMH and removal of ERM were achieved in all eyes and confirmed by SD-OCT after surgery. BCVA improved in 13 eyes (87%; p = 0.002) by more than 1 line (ranged from 20/100 to 20/20) and decreased only in 1 eye (7%) at mean of 9 months after surgery. Pre-operative SD-OCT features including largest diameter of LMH, maximal height of retinal split and subfoveal outer retinal thickness (from retinal pigment epithelial layer to outer boundaries of retinal split) were 835.93±175.03µm, 284.15±83.81µm and 89.84±18.67µm respectively. Among SD-OCT features, only subfoveal outer retinal thickness showed statistically significant better visual outcome after surgery (p = 0.004). Neither pre-operative BCVA nor electrical retinal response densities was associated with statistically significant visual benefit.
Surgical treatment of LMH associated with ERM was useful to achieve anatomical recovery and appears to be useful to improve visual outcome. Subfoveal outer retinal thickness on SD-OCT may be useful to predict better visual outcome after surgery.
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