Abstract
Purpose :
To evaluate OCT and autofluorescence (AF) baseline features and evolution in fellow eyes of patients diagnosed with lamellar macular hole (LMH).
Methods :
Patients diagnosed with LMH and with a long follow-up were retrospectively evaluated in their fellow eyes. Images were obtained with SD-OCT B-SCANS (Heidelberg Spectralis, Heidelberg Engineering, Germany). Foveal retinal thickness was measured from inner layer membrane (ILM) to retinal pigmented epithelium (RPE) inner boundary. The corresponding AF images were evaluated and in eyes with foveal hyperautofluorescence, area of high AF intensity was measured. Vitreous was also examined, when it could not be directly observed it was considered as a completely posterior vitreous detachment (PVD).
Results :
36 patients were included, 15 males and 21 females, with a mean age (± standard deviation) of 78.4 ± 8.0 years. Best corrected visual acuity (BCVA) at baseline was 91 ± 9 letters. The mean follow-up time was 4.6 ± 1.9 years. At baseline six fellow eyes showed a normal retinal profile and a mean foveal thickness of 211.9 ± 61.9 µm, twenty-six had an ERM and in four cases bilateral LMH was evident. PVD was present in thirty patients, four had a vitreo-papillary adhesion (VPA), one showed vitreo-macular adhesion (VMA) and in one eye there were both VMA and VPA. In twenty-four eyes with ERM (92.3%) a concomitant PVD was observed, in the remaining two eyes (7.7%) a VPA was present. In thirty-five eyes retinal profile and foveal thickness did not change significantly during follow up period, also no AF signal variations were detected. One patient developed a LMH at the 3rd year of follow-up.
Conclusions :
In patients with a LMH an ERM is often detected in the fellow-eye. Bilaterally condition is uncommon. As shown for LMH also the evolution of the fellow eye is very slow. LMH development is a long term process that starts with an ERM and proceeds asymmetrically in both eyes. Our data suggest that the presence of a LMH in an eye does not increase significantly the risk to develop the same condition in fellow eye after four years. However the evidence that one of our patient developed a LMH in the fellow eye during a three year follow up, can lead us to suppose that an higher incidence of bilateral disease could be find in a longer span.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.