title: Lamellar macular hole formation in patients with diabetic cystoid macular edema.
abstract: OBJECTIVE
  To report lamellar macular hole formation in four patients with diabetic cystoid macular edema (CME).
  
  
  METHODS
  A review of the medical records of four patients with diabetic CME in whom lamellar macular hole formation was observed. The morphologic changes of CME, seen using optical coherence tomography (OCT), and best-corrected visual acuity were evaluated.
  
  
  RESULTS
  Lamellar macular hole formation had occurred, as determined by slit-lamp biomicroscopy and OCT. Although the inner retinal layer had disappeared, the outer retinal layer was preserved. On OCT, the reflective line of an epiretinal membrane or a posterior hyaloid membrane was seen on the surface of juxtafoveal retina, and visual acuity remained unchanged in all four patients.
  
  
  CONCLUSIONS
  In diabetic patients with CME, the CME occasionally changes spontaneously to a lamellar macular hole. Although the central cystoid space disappears and foveal thickness decreases after this transformation, visual acuity may be little affected as long as the structure of the outer retina remains intact.
authors.affiliation: Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Unoki
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Nishijima
authors.forename: Mihori
authors.initials: M
authors.lastname: Kita
authors.forename: Hideyasu
authors.initials: H
authors.lastname: Oh
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sakamoto
authors.forename: Takanori
authors.initials: T
authors.lastname: Kameda
authors.forename: Hisako
authors.initials: H
authors.lastname: Hayashi
authors.forename: Nagahisa
authors.initials: N
authors.lastname: Yoshimura
mesh_terms: D000368:Aged; D003930:Diabetic Retinopathy / Q000150:complications*; D005260:Female; D005584:Fovea Centralis / Q000473:pathology; D006801:Humans; D008269:Macular Edema / Q000209:etiology* / Q000473:pathology; D055096:Optical Devices; D012167:Retinal Perforations / Q000209:etiology* / Q000473:pathology; D014792:Visual Acuity