Distinct postoperative anatomical outcomes between lamellar macular holes and epiretinal membrane foveoschisis.

BACKGROUND

To compare the postoperative anatomical outcomes between eyes with lamellar macular hole (LMH), epiretinal membrane foveoschisis (ERM-FS) and macular pseudohole (MPH).

METHODS

A retrospective single-centre study, including patients operated for LMH, ERM-FS or MPH, was conducted in a tertiary care centre in Paris, France. LMH eyes underwent vitrectomy with epiretinal proliferation peeling and tamponade, while ERM-FS and MPH eyes underwent ERM peeling without tamponade.

RESULTS

Eighty-three eyes were included with a mean follow-up of 10.4 months: 16 with LMH, 50 with ERM-FS, and 17 with MPH. The mean preoperative central macular thickness (CMT) in LMH eyes (300 ± 43 µm) was thinner than normal and significantly differed from that in ERM-FS and MPH eyes (425 ± 80 µm vs. 380 ± 81 µm, p < 0.0001 and p = 0.02, respectively), which were thicker than normal. In LMH eyes, the mean postoperative CMT remained stable (285 ± 35 µm, p = 0.2) and thinner than in ERM-FS eyes, which was significantly decreased to 371 ± 46 µm (p < 0.0001). The mean postoperative central foveal thickness was significantly increased in ERM-FS eyes (from 191 to 271 µm, p < 0.0001) and in MPH eyes (from 189 to 288 µm, p < 0.0006), while stable compared to before surgery in LMH eyes (141 and 165 µm, p = 0.11) and thinner than normal.

CONCLUSIONS

Lamellar macular hole is a distinct vitreoretinal interface disorder from ERM-FS, with different anatomical postoperative outcomes. Eyes with LMH can improve vision after vitrectomy but its surgical management may differ from that of ERM-FS.