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Lisa Yun, Matthew Farajzadeh, Anibal Andres Francone, Jean-Pierre Hubschman; Lamellar Macular Holes in the Presence of Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3235. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate whether age-related macular degeneration (AMD) has an influence on the anatomical characteristics of lamellar macular holes (LMHs).
A list of patients seen from January 2014 to August 2017 with the diagnosis of AMD was generated. The OCT images were reviewed to grade the AMD as early AMD, intermediate AMD, and late AMD, further classified as dry AMD or wet AMD. The most recent OCTs were also used to identify lamellar macular holes as degenerative or tractional and assess their morphologic characteristics including the presence of epi-retinal proliferation, ellipsoid disruption, and inner and outer LMH diameter. The BCVA and anatomic features of patients with degenerative LMH associated with AMD was compared with a control group including 48 eyes with degenerative LMHs and no AMD selected from a previous publication.
756 eyes (423 patients) were identified with the diagnosis of AMD. 71 were classified as early AMD, 238 as intermediate AMD, and 447 as late AMD (97 with Geographic atrophy (GA) and 350 with wet AMD). The average age of the AMD patients was 81.56±9.62. 162 (38.3%) were males and 261 (61.7%) were females. 25 eyes from 23 patients were diagnosed with LMHs. 22 (88%) of the LMHs were classified as degenerative and 3 (12%) as tractional. Among the degenerative LMHs, 2 eyes were associated with intermediate AMD, 3 eyes with late dry AMD, and 17 eyes with late wet AMD.The BCVA of patients with AMD and a LMH was worse than that of patients with AMD without a LMH (1.06±0.73 vs. 0.69±0.77, p=0.02). Compared to a group of 48 eyes with degenerative LMHs and no AMD selected from a previous publication, the BCVA of patients with degenerative LMH and AMD was worse (1.07±0.73 vs. 0.32±0.26, p=0.0001). The outer diameter of degenerative LMHs with AMD was greater than that of control LMHs (1323.9±999.1 vs. 905.9±356.8, p=0.0121).
The risk of developing a degenerative LMH seems higher in patients with more advanced AMD. Tractional LMHs does not seem to be related to the AMD stage. Degenerative LMHs share a mechanism that is found in macular degeneration.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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