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Choi, Won, Seok, MD*; Merlau, Daniel, J.; Chang, Stanley, MD*

doi: 10.1097/IAE.0000000000001591
Original Study

Purpose: To compare the surgical outcome of a lamellar macular hole (LMH) depending on lamellar hole–associated epiretinal proliferation (LHEP) and full-thickness macular hole.

Methods: This is a retrospective chart review. Thirty-three patients were enrolled for this study. The patients were divided into three groups depending on the type of macular hole and presence of LHEP. Group 1 had epiretinal membranes with LMH without LHEP, Group 2 had LMH with LHEP, and Group 3 had full-thickness macular hole with LHEP. The best-corrected visual acuity was recorded and optical coherence tomography scans were obtained.

Results: Preoperative best-corrected visual acuity showed no significant difference between groups (P = 0.968). Final visual acuity of Group 1 was better than that of Group 2 (P = 0.009). Group 1 showed less postoperative ellipsoid zone disruption compared with Group 2 (P = 0.010), and the duration of LHEP to surgery had no significant correlation with postoperative visual acuity (P = 0.629).

Conclusion: Lamellar macular hole with LHEP showed poorer visual outcomes compared with those with highly reflective epiretinal membranes. Lamellar macular hole with LHEP showed a greater chance of ellipsoid zone disruption. These findings may explain the wide variability of visual outcomes previously reported after vitrectomy for LMH.

A lamellar macular hole with lamellar hole–associated epiretinal proliferation (LHEP) had more severe loss of retinal tissue and greater proportion of ellipsoid zone disruption compared with a lamellar macular hole without lamellar hole–associated epiretinal proliferation. The disruption of the ellipsoid zone seems to be associated with a corresponding scotoma and accounts for decreased and poorer visual outcome after vitrectomy in lamellar macular hole with lamellar hole–associated epiretinal proliferation.

*Department of Ophthalmology, Columbia University, New York, New York; and

College of Arts and Sciences, Columbia University, New York, New York.

Reprint requests: Won Seok Choi, MD, Department of Ophthalmology, Columbia University Medical Center, 635 West 165th Street, New York, NY 10032; e-mail:

Supported by Retina Research Fund, Department of Ophthalmology, Columbia University.

None of the authors has any conflicting interests to disclose.

S. Chang was a consultant for Alcon.

© 2018 by Ophthalmic Communications Society, Inc.