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Takahashi, Hiroyuki, MD*,†; Inoue, Makoto, MD*; Itoh, Yuji, MD*; Koto, Takashi, MD*; Hirota, Kazunari, MD*; Kita, Yoshiyuki, MD*; Hirakata, Akito, MD*

doi: 10.1097/IAE.0000000000002366
Original Study: PDF Only

Purpose: To determine the characteristics of the macular dehiscence–associated epiretinal proliferations (EPs) in eyes with full-thickness macular holes (MHs).

Methods: The presence of EPs and the integrity of the retinal microstructures in eyes with MHs were determined by spectral domain optical coherence tomography in 390 eyes of 379 patients (29–89 years). The clinical findings, closure of the MH, the preoperative and postoperative best-corrected visual acuity, and the microstructural changes were compared between eyes with and without EPs.

Results: Epiretinal proliferations were detected in 31 of 390 eyes (7.9%). The preoperative best-corrected visual acuity and duration of reduced vision were not significantly different in the group with and without EPs (P = 0.09, P = 0.28). The axial lengths were significantly longer (P = 0.001), MH stage more advanced (P = 0.006), and the incidence of epiretinal membranes (P < 0.001) and intraretinal splitting (P < 0.001) were higher in eyes with EP. The EP was significantly correlated with the length of the ellipsoid zone defects (P < 0.001) and medium-reflective bridging tissue over the closed MH (P < 0.001). The closure rates and postoperative best-corrected visual acuities were not significantly different between the two groups (P > 0.99, P = 0.99).

Conclusion: The presence of EP was correlated with retinal microstructural changes and may support postoperative visual improvements with medium-reflective bridging tissue over the closed MH.

Macular dehiscence–associated epiretinal proliferation is seen in eyes with macular holes at advanced stages, an epiretinal membrane, and myopic configurations. The presence of epiretinal proliferation was correlated with the length of the ellipsoid zone defect, but the postoperative visual acuity was not significantly different from eyes without epiretinal proliferations.

*Department of Ophthalmology, Kyorin Eye Center, Kyorin University School of Medicine, Mitaka, Tokyo, Japan; and

Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University (TMDU), Graduate School of Medical and Dental Sciences, Bunkyo-ku, Tokyo, Japan.

Reprint requests: Makoto Inoue, MD, Kyorin Eye Center, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611; e-mail:

None of the authors has any financial/conflicting interests to disclose.

© 2019 by Ophthalmic Communications Society, Inc.