Open AccessLamellar Macular Hole: State of the Art
Author(s) -
Rino Frisina,
Elisabetta Pilotto,
Edoardo Midena
Publication year - 2019
Publication title -
ophthalmic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.893
H-Index - 54
eISSN - 1423-0259
pISSN - 0030-3747
DOI - 10.1159/000494687
Subject(s) - foveal , macular hole , retina , optical coherence tomography , epiretinal membrane , ophthalmology , fovea centralis , medicine , optometry , optics , visual acuity , retinal , vitrectomy , physics
Lamellar macular hole (LMH) is a vitreoretinal disorder characterized by an irregular foveal contour, a break in the inner fovea, dehiscence of the inner foveal retina from the outer retina, and the absence of a full-thickness foveal defect with intact foveal photoreceptors. The pathogenesis is only partially known. The advent of high-resolution optical coherence tomography has allowed distinguishing between two types of epiretinal membrane (ERM) associated with LMH: a conventional ERM (commonly found in macular pucker) and an atypical ERM (known by varied names: dense, epiretinal proliferation, or degenerative). These two types of ERM not only influence LMH morphology but also differ in cell and collagen composition. It remains unclear if these two types are indeed two distinct clinical entities or rather two stages of the same macular disorder. Studies of the natural evolution of LMH have not fully resolved this issue and also offered variable results. Surgical treatment leads to excellent anatomical and functional outcomes, but not without risks. This review provides a critical summary of the available data on LMH including some new insights.