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A. Peroglio Deiro, F. Bottoni, C. Orini, M. V. Cigada, G. Staurenghi; Evolution of Lamellar Macular Hole Using SD-OCT. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4416.
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to study the evolution of lamellar macular holes using SD-Optical Coherence Tomography .
patients diagnosed as having a lamellar macular hole have been followed prospectively since January 2009. Inclusion criteria were a foveal defect on SD-OCT ( Spectralis HRA + OCT, Heidelberg Engineering , Heidelberg, Germany ) with residual foveal tissue above the retinal pigment epithelium and corresponding hyperautofluorescence on fundus autofluorescence imaging. Visual acuity and OCT findings were collected and compared at baseline and after 6 months of follow up. Main outcome measures were visual acuity changes ( ETDRS charts ) and progression of the lamellar macular defect. The latter was evaluated by measuring the distance between the inner/outer segment ( IS/OS ) interface and the internal limiting membrane in the fovea ( software calipers ).
Seventeen eyes of 17 consecutive patients ( 8 males 9 females ), mean age 71 years ( range 53 - 86 ), mean refraction -0,5 sph ( range +2,5/-5,0 sph ) were included in the analysis. Mean BCVA at baseline ( 62 letters ETDRS ) and after 6 months ( 60 letters ETDRS ) was stable ( signed rank test, p value 0,109 ). Mean foveal thickness at baseline ( 119 microns ) and after 6 months ( 112 microns ) was stable ( signed rank test, p value 0,935 ). The patient with the thinnest residual foveal tissue developed a full thickness macular hole loosing also a line on the ETDRS chart . Seventeen eyes ( 100% ) had an ERM and 8 ( 47% ) a posterior vitreous detachment at baseline. A weak correlation between visual acuity and thickness of residual foveal tissue at baseline ( p 0,02 correlation coefficient 0,44 ) and after 6 months follow up ( p 0,37 correlation coefficient 0,24 ) was finally detected.
Lamellar macular holes at 6 months seem to be stable with no progression. Full thickness macular hole may develop in eyes with a very thin layer of residual tissue during follow up.
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