The development and evolution of lamellar macular hole in highly myopic eyes

Background/Objectives To study the development, evolution, outcomes, and prognostic factors of lamellar macular hole (LMH) in highly myopic (HM) patients. Methods Fifty eyes from 47 HM patients with LMHs were retrospectively enrolled. Relevant pre- and post-LMH optical coherence tomography findings...

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Bibliographic Details
Published in:Eye (London) 2023-04, Vol.37 (6), p.1170-1177
Main Authors: Hsia, Yun, Lee, Cheng-Yung, Ho, Tzyy-Chang, Yang, Chang-Hao, Yang, Chung-May
Format: Article
Language:English
Subjects:
692/699/3161/1626
692/699/3161/3175
Acuity
Epiretinal Membrane
Evolution
Eye
Follow-Up Studies
Humans
Laboratory Medicine
Medicine
Medicine & Public Health
Myopia - complications
Ophthalmology
Pharmaceutical Sciences/Technology
Retinal Perforations - diagnosis
Retinal Perforations - etiology
Retinoschisis
Retinoschisis - etiology
Retrospective Studies
Surgery
Surgical Oncology
Thinning
Tomography, Optical Coherence - methods
Visual Acuity
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Summary:Background/Objectives To study the development, evolution, outcomes, and prognostic factors of lamellar macular hole (LMH) in highly myopic (HM) patients. Methods Fifty eyes from 47 HM patients with LMHs were retrospectively enrolled. Relevant pre- and post-LMH optical coherence tomography findings and visual acuity were collected. Structural progression was defined as an increase in the height of retinoschisis, and the development of foveal detachment, full-thickness macular hole, or retinal detachment. Results Four traction-related developmental processes were identified. Type 1 LMHs (8, 16%) developed from foveal avulsion caused by vitreomacular traction. Type 2 (32, 64%) and type 3 LMHs (5, 10%) formed from ruptured parafoveal and central foveal cysts, respectively. Progressive foveal thinning caused by epiretinal membranes (ERMs) without cystic changes led to type 4 LMHs (5, 10%). Retinoschisis developed before (9 eyes), after (10 eyes), or simultaneously with (6 eyes) the LMH formation. Structural progression was noted in 50%, 53%, 0%, 100% of patients with type 1–4 LMHs, respectively. Multivariable Cox proportional hazard model showed that greater residual foveal thickness ( P  = 0.001, adjusted odds ratio = 0.22, 95% confidence interval [CI], 0.08 ~ 0.56), and the absence of retinoschisis were protective against structural progression. Multivariable linear regression showed that poor baseline visual acuity ( P  
ISSN:0950-222X
1476-5454
DOI:10.1038/s41433-022-02086-3