Abstract
Purpose :
to investigate wheter different types of lamellar macular hole (LMH) show different patterns of evolution of blue fundus autofluorescence (B-FAF) after surgery.
Methods :
Twenty eyes of 20 patients affected by LMH as imaged with spectral domain optical coherence tomography (SD-OCT) and showing an increased autofluorescent signal at the fovea on B-FAF were investigated. All eyes underwent pars plana vitrectomy and peeling of epiretinal membranes (ERMs) and internal limiting membrane. After operation, patients were followed-up for 12 months. Main outcome measures were measurements of the area of inceased B-FAF and logMAR best-corrected visual acuity (BCVA).
Results :
three types of LMH were identified before operation: 1) idiopathic, associated with tractional ERM (10 eyes); 2) idiopathic, associated with lamellar hole-associated epiretinal proliferation (LHEP,7 eyes); 3) secondary to cystoid macular edema (CME, 3 eyes). The preoperative mean area of increased B-FAF was 0.23, 0.26 and 0.32 mm3 in group 1, 2 and 3 respectively (P= 0.45) and decreased to 0.09, 0.15 and 0.28mm3 at 12 months after surgery. The change of size was significant in group 1 and 2 (P< 0.001 ). LogMAR BCVA continuosly improved during the postoperative period in the idiopathic cases (P< 0.001 at month 12); conversely no improvement was found in the LMHs secondary to CME.
Conclusions :
in idiopathic LMHs, indipendent of the associated epiretinal material (tractional ERM or LHEP), the area of increased B-FAF decreases after surgery whereas it does not change significantly in eyes with LMH secondary to CME. A significant improvement of LogMAR BCVA is observed exclusively in the eyes with idiopathic LMH.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.