title: LAMELLAR HOLE-ASSOCIATED EPIRETINAL PROLIFERATION: A Clinicopathologic Correlation.
abstract: OBJECTIVE
  To correlate clinical and optical coherence tomographic features with histopathological and immunohistochemical findings in an eye undergoing surgical excision of lamellar hole-associated epiretinal proliferation (LHEP).
  
  
  METHODS
  An eye with a lamellar macular hole and LHEP without a tractional epiretinal membrane component was identified with spectral-domain optical coherence tomographic imaging and underwent pars plana vitrectomy with LHEP and internal limiting membrane peeling and gas tamponade. The surgically excised LHEP specimen was analyzed with histopathological and immunohistochemical staining using flat-mount preparation techniques. Postsurgical outcomes including visual acuity and optical coherence tomographic imaging were reviewed.
  
  
  RESULTS
  With spectral-domain optical coherence tomography, the lamellar macular hole was found to be closed with no residual LHEP after the surgery. Visual acuity improved from 20/200 preoperatively to 20/40 at 6 months after the surgery. Histopathological and immunohistochemical analyses of the LHEP specimen revealed retinal glial cells that reacted positively with anti-glial fibrillary acidic protein and anti-glutamine synthetase, a Müller cell-specific antibody.
  
  
  CONCLUSIONS
  Lamellar macular hole with LHEP may demonstrate closure after pars plana vitrectomy with LHEP and internal limiting membrane peeling and gas tamponade. There was considerable improvement in visual acuity. It is possible that LHEP originates from middle retinal layers of the lamellar hole defect because it contains retinal glial cells, specifically Müller cells.
authors.affiliation: *Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada; †Vitreous Retina Macula Consultants of New York, New York, New York; ‡LuEsther T. Mertz Retinal Research Center, Manhattan Eye Ear and Throat Hospital, New York, New York; §Department of Ophthalmology, New York University School of Medicine, New York, New York; and ¶Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Claudine E
authors.initials: CE
authors.lastname: Pang
authors.forename: David A
authors.initials: DA
authors.lastname: Maberley
authors.forename: K Bailey
authors.initials: KB
authors.lastname: Freund
authors.forename: Valerie A
authors.initials: VA
authors.lastname: White
authors.forename: Steve
authors.initials: S
authors.lastname: Rasmussen
authors.forename: Eleanor
authors.initials: E
authors.lastname: To
authors.forename: Joanne A
authors.initials: JA
authors.lastname: Matsubara
mesh_terms: D000368:Aged; D058450:Endotamponade; D019773:Epiretinal Membrane / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D012167:Retinal Perforations / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D014821:Vitrectomy
chemical_list: D013459:Sulfur Hexafluoride