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Jessica Lee, Rahul Mandiga, Lawrence J Singerman, Llewelyn Rao; Long-Term Follow-Up Study on the Natural Progression of Lamellar Macular Holes. Invest. Ophthalmol. Vis. Sci. 2014;55(13):317.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the natural progression of lamellar macular holes (LMH) and their visual prognosis in a large retrospective cohort of patients.
The charts of 87 eyes of 78 patients with a diagnosis of macular hole by ICD coding (362.54) were identified from 2008-2013. The patient charts were retrospectively reviewed and only those patients with a diagnosis of a lamellar macular hole as confirmed by an Ocular Coherence Tomography (OCT) scans were included in the study. None of the patients had undergone surgery for lamellar macular hole repair. Baseline visual acuity (VA) and endpoint VA were recorded. Main outcome measures were best-corrected visual acuity (BCVA), influence of an epiretinal membrane (ERM) on the LMH, posterior vitreous detachment (PVD), and history of diabetes or hypertension.
The patients included 52 females and 26 males with a mean age of 71 years. The mean follow-up time was 3 years (range 1.83 months to 16 years). At the time of diagnosis, the mean visual acuity was 20/50. At the end of follow-up, the mean visual acuity was 20/60. More than 55% were found to have a PVD and 64% were found to have an ERM. Only 11% of LMH were associated with a concomitant diagnosis of diabetes mellitus and 52% of LMH were associated with hypertension.
This long term study of a large cohort of patients revealed that the majority of LMH occurs in elderly women and is commonly associated with an ERM. LMH patients appear to have relatively good visual acuity that tends to remain stable with observation alone without requiring immediate surgical intervention.
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